High burnout reported among staff working in ABA-based autism services in Brazil

A new study in the Journal of Autism and Developmental Disorders reports high levels of burnout among professionals working in Applied Behavior Analysis (ABA)-based services in Brazil.

ABA is a behaviour-based approach offered to autistic people. It is contested, and it is not a neutral form of support. This paper does not test whether ABA helps or harms autistic people. It looks only at the wellbeing of the people who deliver it.

What the researchers did

The team ran a survey of ABA professionals working in different regions of Brazil. The authors note there is little data on this from low- and middle-income countries.

Participants completed the Maslach Burnout Inventory–Human Services Survey, a burnout questionnaire for people in human-service jobs. It measures burnout in three areas:

• emotional exhaustion (feeling drained by work)
• depersonalisation (feeling detached from, or cold towards, the people you work with)
• personal accomplishment (a sense of doing the job well; low scores point to more burnout)

Participants also answered questions about themselves and their work. The researchers then compared burnout across job roles, age groups, academic backgrounds, pay bands and caseload.

What they found

Burnout indicators were common in this group:

• 77.4% had high emotional exhaustion
• 89.9% had low personal accomplishment
• 34.1% had high depersonalisation

The share of people in the most severe category rose from behaviour technicians to coordinators to supervisors, across all three areas. Staff managing more than 10 cases at once were more likely to show high depersonalisation and low personal accomplishment. Burnout looked similar across pay bands.

The authors say their findings point to the need for responses at the level of organisations and systems. They suggest that better working conditions, supervision and support may improve staff wellbeing and, in turn, the quality of care for autistic people.

Why this matters, and what to be careful about

When staff feel exhausted and detached from the people they work with, that is worth taking seriously. Autistic people are on the receiving end of these services. High depersonalisation among workers delivering an already contested approach is a concern in its own right.

But the claim that better staff wellbeing leads to better care for autistic people is the authors’ suggestion. This study did not measure it.

Limitations

• Sample size not given. The abstract does not say how many people took part, or how they were recruited.
• Not representative. The authors say plainly that the results describe the people surveyed, not the whole ABA workforce in Brazil.
• Snapshot design. This was a cross-sectional survey, meaning it captured one moment in time. It shows patterns, not causes. For example, it can’t tell us whether big caseloads cause burnout.
• Descriptive only. The results are reported as percentages in categories. The abstract does not describe statistical tests between groups.
• Self-report. Burnout was measured by questionnaire, not observed.
• Autistic people’s views missing. According to the abstract, only professionals were surveyed. Autistic people and their families were not asked about their experiences of these services. The abstract does not say whether autistic people helped design or run the research.
• ABA itself not examined. As described in the abstract, the paper treats ABA services as a workplace. It does not test whether ABA is appropriate.

This piece summarises the paper’s abstract. Read the paper for the full methods and findings.