The Pathology of Childhood Behavior: When Does It Go Too Far?

You were trained to reduce problem behavior.
You learned how to graph tantrums, prompt compliance, and write goals that fit neatly into treatment plans.

But no one prepared you for the moment an autistic adult told you that your “intervention” felt like abuse.

No one explained how it would feel to sit across from a child whose joy, pain, and self-expression were all being measured, monitored, and shaped—because the system told you to.

And now, you're stuck between two worlds:
One that tells you to follow the data, and another—growing louder by the day—that asks you to follow your conscience.

If you’ve ever questioned whether your goals serve the child or the system...
If you’ve ever stayed up at night wondering whether you're helping kids thrive or just helping them comply...
This is the conversation you've been craving—and the one our field can no longer avoid.

Key Takeaways

• Not all challenging behavior is pathological

• Autistic children are often held to higher standards

• Context matters more than topography

• Masking is a red flag, not a success

• Environments shape behavior

• Ethical ABA prioritizes dignity and autonomy

• Focus on building capacity, not just compliance

• Ask better questions before writing goals

• Success means safety, self-expression, and confidence

What Is Pathologizing Childhood Behavior?

Pathologizing childhood behavior means treating developmentally expected actions—like tantrums, refusals, or the need to move—as symptoms of something wrong, rather than natural expressions of growth, frustration, or communication.

It’s when a four-year-old throws a toy in frustration and we call it “aggression.”
When a seven-year-old says “no” and we call it “non-compliance.”
When a ten-year-old rocks or flaps to regulate—and we label it “disruptive.”

In the world of behavior analysis, we’re taught to describe behavior objectively, to avoid value judgments. But even data-driven systems can carry bias—especially when societal norms about what’s “acceptable” drive our definitions of what’s “challenging.”

And research backs this up.

Studies like Wakschlag et al. (2012) found that even pediatricians and mental health professionals often overpathologize behaviors like tantrums and irritability—especially in young children from marginalized or neurodivergent populations. What’s normal for one child is labeled a problem in another, depending on diagnosis, identity, or setting.

This matters deeply in ABA.

Because when we frame behaviors as deficits without considering context, we risk designing interventions that suppress—not support—a child’s development.

Example 1: Stimming
An autistic child rocks gently during circle time. Instead of asking “What purpose is this serving?” the behavior gets written up as “inappropriate.” A goal is created to reduce it—yet it may have been that child’s way of staying regulated, calm, or engaged.

Example 2: Refusal
A teenager refuses to complete a math worksheet after a hard day. Instead of interpreting this as communication—or a need for co-regulation—it’s marked as “defiance” and prompts are added until they comply.

Each time we do this, we risk teaching kids that their body’s signals are wrong, their boundaries aren’t valid, and that success means silence.

And yet—these are behaviors we expect to see in development. Kids tantrum. They test limits. They say no. They stim to cope. None of these are inherently pathological. They’re part of becoming human.

Shifting Standards: Why Are Autistic Kids Held to a Higher Bar?

It’s a familiar scene for many BCBAs®:

You’re reviewing session notes, analyzing data, or sitting in an IEP meeting. The child you support is following instructions, transitioning with support, using functional communication, and showing real progress.

But somehow, it’s not enough.

There’s still pressure to add goals. Still talk of “non-compliance.” Still a push to reduce behaviors that, if we’re honest, aren’t all that different from what we’d expect from any child their age.

And yet—they’re the one with the behavior intervention plan.
They’re the one in services 20 hours a week.
They’re the one being measured, tracked, corrected.

We say we individualize treatment. But too often, autistic children are measured against standards built for the neuro-majority. And the unspoken expectation? That they must behave better than their peers just to be seen as doing well enough.

That’s not just unfair—it’s unethical.

As Wakschlag et al. (2012) remind us, behaviors like tantrums, refusals, and emotional outbursts are common in early childhood development. These behaviors are not inherently pathological; their meaning depends on context, frequency, and intensity.

So why do we treat them as red flags when they come from autistic children?

The answer lies in how our systems—education, insurance, even some ABA models—treat diagnosis as a justification for intervention, rather than a lens for understanding. The moment a child receives an autism diagnosis, typical behaviors are no longer viewed as typical. They're reclassified as symptoms.

A neurotypical three-year-old who refuses to clean up is “just being three.”
An autistic three-year-old who refuses to clean up is written up as “non-compliant.”

Same behavior. Different label. Different treatment plan.

And when services are funded based on “behavioral excesses,” we may unconsciously begin hunting for behaviors to justify continued hours—even if those behaviors are developmentally expected.

This becomes especially apparent in school settings. Many interventions aren’t based on the child’s needs, but on how disruptive their behavior is to others. If a behavior challenges the system, it's pathologized. If it quietly harms the child (like masking), it’s often overlooked.

And yet, research shows that all children struggle with regulation, compliance, and autonomy development—especially in overstimulating or rigid environments. The difference is, autistic kids are often the only ones being written up for it.

Behavior ≠ Bad: Reframing “Challenging”

As behavior analysts, we’re trained to remain objective—to observe, measure, and describe behavior without judgment. But let’s be honest: even our most clinical terminology carries weight.

Words like non-compliant, aggressive, or disruptive don’t just describe what a child is doing. They imply that what the child is doing is wrong.

But what if it’s not?

What if the child who yells “no!” is setting a boundary?
What if the one who runs away is overwhelmed—not escaping demands, but seeking regulation?
What if the child who resists a worksheet isn’t refusing to learn, but refusing to mask?

Many of the behaviors we call “challenging” are only considered problems because they happen at inconvenient times—or because they come from children we’ve been trained to “fix.”

As VanDevander et al. (2024) found in their normative behavior study, behaviors like tantrums, refusals, and even aggression were commonly observed among neuro-majority children—at rates that often mirror or exceed those in clinical populations. The difference? Those kids aren’t in services, so the behaviors aren’t scrutinized the same way.

This is where we need to ask a harder question:
Are we targeting behaviors because they’re actually impeding the child’s life—or because they’re making someone else uncomfortable?

Behavior in Context

“No behavior is inherently inappropriate. It’s all about context.”
—Amelia Dalphonse, MA, BCBA®

We wouldn’t call aggression inappropriate if someone was defending themselves from harm. We wouldn’t call a child’s refusal “non-compliance” if they were advocating for their own limits.

So why do we apply those labels so quickly in clinical settings?

When we assess behavior without considering context—sensory overload, trauma history, co-occurring conditions, lack of communication—we risk turning natural, adaptive responses into clinical problems.

What Are We Really Teaching?

We say we’re building skills. But if those skills are built on suppression—if they require a child to abandon their natural ways of communicating, regulating, or protecting themselves—are we really helping?

Teaching replacement behavior without understanding the purpose of the original behavior is like paving over a pothole without fixing the sinkhole beneath it.

Listen & Reflect: How Far Is Too Far?

You’ve had that moment—the one where the behavior plan checks every box, the data trends in the “right” direction, and still… something doesn’t feel right.

Maybe it’s the IEP meeting where you’re asked to target hand-flapping, even though you know it’s helping the child stay regulated.
Maybe it’s the pressure to write reduction goals for behaviors that aren’t harmful—just inconvenient for the adults in the room.
Maybe it’s that uncomfortable pause between your clinical recommendation and a caregiver’s desperate plea:

“But can’t you just make it stop?”

You follow the science. You believe in behavior analysis.
And yet—you’ve also read the blogs, listened to autistic advocates, and started asking harder questions than your supervision ever prepared you for.

That’s exactly the space explored in the Action Insights Podcast episode, “The Pathology of Childhood Behavior: When Does It Go Too Far?” featuring Nikki Dionne, LCMHC, BCBA®, and Amelia Dalphonse, MA, BCBA®.

In this conversation, they dig into the complex territory where clinical training and ethical reflection collide—where the science says one thing, but lived experience from autistic individuals tells another story.

Together, they examine:

• Why typical behaviors in autistic children are so often labeled “challenging”

• How masking, compliance, and skill acquisition are sometimes conflated in our treatment goals

• What we risk—ethically, emotionally, and developmentally—when we focus on eliminating behaviors rather than understanding them

If you’ve ever wondered how to balance data with dignity, or felt caught between what your training taught you and what feels right in your gut, this episode is essential listening.

🎧Listen to: The Pathology of Childhood Behavior: When Does It Go Too Far?→

This isn’t just a conversation about practice. It’s a call to reimagine what ethical, neurodiversity-affirming behavior analysis can look like—and what it must become.

The Hidden Harm of “Fixing” Natural Behavior

Most of us entered this field with the intention to help—to teach, support, and empower. But when we focus on eliminating behavior without understanding its purpose, we may unintentionally do the opposite.

We may teach kids that their way of being is wrong.
That their instincts are flawed.
That safety comes from staying quiet, still, and compliant—even when it hurts.

This is what autistic individuals describe when they talk about masking.

Masking is the suppression of natural behaviors—like stimming, scripting, or avoiding eye contact—in order to appear more “typical.” It’s often praised in childhood as “progress.” But in adulthood, it’s linked to profound mental health consequences.

A growing body of research—including studies by Cage et al. (2018)—has linked autistic masking to increased rates of anxiety, depression, identity confusion, and suicidal ideation.

These aren’t side effects. They’re the result of a system that teaches children to perform a version of themselves that makes others more comfortable.

And often, it starts with us.

When we write goals to reduce “hand flapping” or “verbal perseveration” without first understanding why the behavior occurs…
When we prioritize compliance over consent…
When we reinforce “quiet hands” without offering sensory alternatives…

We may be reinforcing not safety or success—but silence.

In their 2024 study, VanDevander et al. found that many so-called “problem behaviors” like yelling, refusing, and even mild aggression appear frequently in neurotypical children. The difference? Those children aren’t being taught to suppress who they are to gain access to community, education, or adult approval.

That’s what makes this so important.

Because the children we work with won’t always be children. They’ll grow into adults who remember whether they were accepted or corrected. Whether they were understood or shaped. Whether their needs were met—or masked.

This isn’t about rejecting behavior analysis. It’s about evolving it.

Because true support doesn’t come from “fixing” natural behavior.
It comes from honoring it, understanding it, and helping children navigate the world without losing who they are.

What If the Problem Isn’t the Child—It’s the Environment?

We spend a lot of time analyzing behavior. But what if, instead, we started analyzing the environments?

What if the tantrum isn’t a skill deficit—but a perfectly reasonable response to a system that expects a five-year-old to sit still for six hours a day?
What if the refusal isn’t non-compliance—but a boundary in a classroom that offers no autonomy?
What if the “disruption” isn’t the child’s behavior—but the rigid, one-size-fits-all structure around them?

When we zoom out, it becomes clear: many behaviors we’re asked to fix are adaptive responses to environments that weren’t designed with all brains in mind.

And that’s not a child’s failure. It’s a design flaw.

According to Dunn’s Sensory Processing Framework (1997), behavior is often the result of a mismatch between a person’s sensory profile and the demands of their environment. When we modify the environment—even slightly—behavior often improves without a single goal being written.

The Sit-Still Myth

Think about the average school day.
Now imagine asking an adult to sit attentively at a desk for six hours, with only brief breaks, minimal control over their tasks, constant sensory input, and social expectations layered on top.

We’d call that unreasonable.
But we ask it of children—every single day.

And when they resist, they’re labeled disruptive, disordered, or developmentally delayed.

As discussed in the podcast, Nikki Dionne shared that for her—an adult with ADHD, sensory processing challenges, and a tic disorder—sitting through a single six-hour training is exhausting. So why do we expect more of a second grader?

The truth is, many “problem behaviors” would disappear entirely if we redesigned classrooms, clinics, and homes to support regulation, flexibility, and autonomy.

Universal Supports Aren’t Just for Some Kids

We often talk about accommodations as something reserved for children “in services.” But what if noise-canceling headphones, visual supports, co-regulation spaces, and movement breaks were available to everyone?

What if we normalized sensory diversity instead of medicalizing it?

This shift doesn’t just help neurodivergent children—it lifts the standard for all learners. And it reduces the social divide between those who are “in special ed” and those who are not.

Real-world idea: Instead of writing a goal to reduce covering ears, create a classroom where headphones are available to all. You may find that multiple children use them—and fewer behaviors need to be “addressed.”

If we’re truly committed to ethical, effective, and affirming ABA, we must stop assuming the child is the one who needs to change.

Because behavior is never just about skill. It’s about safety. About expression. About context.

Sometimes the best intervention isn’t a new behavior plan—it’s a new lens.

What Should BCBA®s Actually Do?

If your stomach has been in knots reading this—good.
Not because discomfort is the goal, but because it means you care. You’re paying attention. You’re ready to do better.

The good news? There’s a better way.
A more ethical, human-centered, and still evidence-based approach to behavior analysis.
It doesn’t require abandoning ABA. It requires realigning it.

Let’s start with three foundational questions that can guide your next treatment plan, goal proposal, or supervision conversation:

1. Is this behavior actually developmentally inappropriate?

Before writing a reduction goal, pause. Ask: Would this behavior be concerning if the child were neurotypical?

If not, you may be holding the child to a higher standard simply because of their diagnosis.

VanDevander et al. (2024) provide a helpful reference point here—their study offers a reference range of problem behaviors in neurotypical children. It’s a must-read when considering whether a behavior is truly “excessive” or simply part of being a kid.

2. Is this behavior harming the child—or just bothering the adults?

This is a gut-check moment. Behavior may be undesirable to teachers or caregivers, but that doesn’t automatically make it unsafe or unethical to allow.

If the behavior isn't dangerous, ask:

• Is it interfering with the child’s ability to connect, learn, or regulate?

• Or is it primarily disrupting an inflexible system?

If it’s the latter, the more ethical solution may be environmental redesign—not behavior suppression.

3. Are we teaching new skills—or just reinforcing masking and compliance?

This question changes everything.

If your intervention teaches a child to raise their hand instead of shouting, great.
But if it teaches them to suppress all vocalizations unless they’re scripted or prompted? That’s not communication—that’s conditioning.

According to the BACB® Ethics Code (2022), Section 2.06, we’re obligated to promote client dignity and autonomy. That means creating goals that foster self-advocacy, self-determination, and natural expression—not just external approval.

What Ethical, Affirming ABA Looks Like

Here’s what to aim for in your everyday work:

• Use assent-based practices. Let the child’s behavior guide the pace of intervention. If they consistently resist a task, that’s not non-compliance—it’s communication.

• Reframe “non-compliance” as autonomy. Instead of writing goals to increase task completion, write goals that build flexible problem-solving or support regulation prior to transitions.

• Choose replacement behaviors that feel natural. Don’t replace scripting with full sentence prompts. Replace it with something that actually serves the same emotional or communicative function.

• Partner with families and caregivers. Validate their concerns, but also educate them on what’s developmentally typical. Bring the science and the compassion into the room together.

• Supervise with nuance. Train RBT®s and early-career BCBAs® to consider context, culture, trauma, and neurodiversity. Encourage questioning, not just compliance.

There’s no perfect formula for ethical behavior analysis. But there is a guiding principle:

If your intervention takes something away from the child—their voice, their joy, their sense of safety—you need to reevaluate the goal.

From Compliance to Capacity: Redefining Success in ABA

When we first enter this field, we’re taught that success looks like fewer tantrums.
More task completion.
Quiet hands. Still bodies. Yes ma’am. Good job.

But that’s not success.
That’s compliance.

And compliance is cheap.
It can be trained. It can be prompted. It can be reinforced.

What’s harder—and far more meaningful—is building a child’s capacity.

Capacity to regulate.
Capacity to express themselves in a way that feels authentic.
Capacity to advocate for what they need—even if it’s inconvenient to others.

Because our clients won’t always be children in therapy rooms with token boards and reinforcement schedules.

They’ll be teenagers deciding when to say no.
Adults navigating relationships, workplaces, and systems that aren’t built for them.
People choosing when to mask and when to unmask—and dealing with the consequences of either choice.

If we’ve only taught them to comply, we’ve failed.
But if we’ve helped them build the skills to be their full selves—even in a world that doesn’t always understand them—we’ve done something profound.

The real goal of ABA isn't behavior change. It's human empowerment.

Rethink Your Treatment Plan

Instead of asking:

How can we reduce this behavior?

Ask:

What is this behavior telling us about the child’s needs, stress, or environment?
What skill would allow them to meet that need more effectively—without losing themselves in the process?

Rethink Your Data

Instead of only tracking frequency and duration, consider measuring:

• Instances of self-advocacy

• Attempts at emotional expression

• Engagement in preferred activities

• Use of coping strategies in natural contexts

These are the kinds of outcomes that actually matter in real life.

Rethink Your Legacy

Every BCBA® leaves behind more than graphs and goals.
You leave behind an impact—a legacy of how your clients feel about themselves, about learning, and about their right to take up space in this world.

What if your legacy wasn’t just about reducing behaviors...
…but about increasing hope?

What if your clients remembered you not as the person who taught them to “behave”—
…but as the person who helped them feel safe being who they are?

Check out the episode of the Action Insights Podcast that discusses this important topic!

References

Cage, E., Di Monaco, J., & Newell, V. (2018). Experiences of autism acceptance and mental health in autistic adults. Journal of Autism and Developmental Disorders, 48(2), 473–484. https://doi.org/10.1007/s10803-017-3342-7

Dunn, W. (1997). The impact of sensory processing abilities on the daily lives of young children and their families: A conceptual model. Infants & Young Children, 9(4), 23–35. https://doi.org/10.1097/00001163-199704000-00005

Hanley, G. P., Jin, C. S., Vanselow, N. R., & Hanratty, L. A. (2014). Producing meaningful improvements in problem behavior of children with autism via synthesized analysis and treatment. Journal of Applied Behavior Analysis, 47(1), 16–36. https://doi.org/10.1002/jaba.106

Taylor, B. A., LeBlanc, L. A., & Nosik, M. R. (2021). Ethical considerations and recommendations for the use of trauma-informed behavior analytic practices. Behavior Analysis in Practice, 14(3), 912–922. https://doi.org/10.1007/s40617-021-00596-6

VanDevander, J., Clark, M., & Peters, B. (2024). Creating a reference range of common problem behaviors and replacement behaviors in neurotypical children. Behavioral Interventions, 39(1), e1978. https://doi.org/10.1002/bin.1978

Wakschlag, L. S., Choi, S. W., Carter, A. S., Hullsiek, H., Burns, J. L., McCarthy, K., ... & Briggs-Gowan, M. J. (2012). Defining the developmental parameters of temper loss in early childhood: Implications for developmental psychopathology. Journal of Child Psychology and Psychiatry, 53(11), 1099–1108. https://doi.org/10.1111/j.1469-7610.2012.02595.x