Brasília, October 2, 2023
Considering our unconditional defense of the principles of Inclusive Education as a right won and sustained by the current National Policy on Special Education from the Perspective of Inclusive Education/PNEEPEI (2008), we express our concern and opposition to: the succession of bills that are multiplying exponentially in several Brazilian states and municipalities that aim to introduce the figure of a therapeutic assistant (TA) in schools, together with the compulsory recommendation of the ABA method (Applied Behavior Analysis) to be adopted by this professional; the attempt to alter the National Policy on Inclusive Education, on an urgent basis, through Bill 3035/2020, reported by federal deputy Duarte Jr (PSB); the ostensive dissemination by the press of narratives of violence against students with disabilities in the school environment. All these aspects suggest an attack on the School as an institution, on the person with a disability, treated as an object-part in negotiations in the Legislature, and an alienation from the material conditions imposed on Brazilian schools (see the COMEX/MEC/2021 report), which prevent or hinder the construction of an inclusive, hospitable and welcoming environment for all children, not only for students with disabilities.
The alarmist discourse about the need to include new professionals in school systems who act from clinical rather than educational approaches disrespects the Federal Constitution and the Statute of Persons with Disabilities (13.146/2015), which define the social model of disability as the paradigm for implementing public policies in Brazil. The social model, affirmed by the International Convention on the Rights of Persons with Disabilities (UN/2006) and incorporated into Brazilian law as a constitutional amendment (Decree 6949/2009), leaves in the past the biomedical model centered on ‘diagnosis’ and ‘therapeutic approaches’ and invites us to understand autism and other experiences read as neurodevelopmental disorders as a way of inhabiting the world.
It is outrageous that the National Congress, when discussing Education, is opening space for discourses that advocate a therapeutic and behavioral-adjustment bias, ableist in nature, and that it does so hastily, contrary to democratic principles, based on the discourse of health professionals, businesspeople and lawyers, and not of teachers, researchers in the field of Education and users of public school services. Likewise, the positions of the Ministry of Health, Ministry of Education, Ministry of Social Development and Ministry of Human Rights, as well as other Executive bodies, have proven ineffective in this confrontation, which further weakens the conditions of struggle and life of people with disabilities, deepening inequalities, including in the dispute over public policies.
The arguments used to justify introducing the TA suggest behavior control of autistic students, considered challenging to environments and corponormative ideals. Another aspect that draws attention is the imposition of a therapeutic approach, ABA, in the school environment, compulsorily tied to the introduction of the TA in schools, which crosses important ethical limits in the handling of public affairs, since it is an extremely costly approach that is imposed as the only alternative to meet the most diverse demands of people on the autism spectrum, which violates the autonomy of professionals in applying their knowledge, the necessary plurality of approaches in the field of health, and removes the freedom of choice of the child, their families, professionals and even the school.
Coordination between the fields of Health and Education is necessary to expand care for people with disabilities by offering supports for the elimination of barriers to the development of their autonomy and participation in society. However, it is not methods and techniques that should guide the government in designing actions and programs, but policies that guarantee the equitable distribution of care. The legal frameworks underpinning public policies, and the principles and guidelines that structure the Unified Health System/SUS and the organization of school systems in the country, must be respected, with guaranteed investment of material, human and financial resources, which do not overlap the fields and are oriented by geopolitically constituted knowledge.
We stress the need to consider the entire normative framework that makes up the National Policy on Special Education from the Perspective of Inclusive Education, which includes the Technical Notes and Resolutions of the Ministry of Education, which already provide for the Support Professional Service for students with needs related to feeding, hygiene, mobility and communication, beyond the care already offered to other students. We emphasize here that care is part of the mandate of Education, and is also an educational responsibility in the school space.
Defending the hypothesis that the therapeutic assistant would have differentiated competence to deal with students in Special Education is to presume incompetence in the work of teachers. This premise perverts the institutional nature of the school, seeking to turn it into a clinic-school, at the service of private and corporatist interests and not of the public interest, and stripping children with disabilities of their place as students to impose on them the place of patients.
Proposals for therapeutic intervention in Education, such as those found in these bills, disregard that behavior and learning are collective and cultural productions, and must be approached and experienced in the pedagogical and educational field. The school must not be occupied by expert-assessment functions and by the tracking of so-called deviant behaviors, nor be concerned with controlling bodies in order to homogenize and normalize them.
It should also be stressed that, although there is a large body of academic research investigating the use of ABA, there is a great difference between the contexts where it is tested (in specific populations, different from Brazilian ones) and the outcomes expected after its application are still modest if we think of it as the only or main approach to be used in Brazil. Behavioral approaches may be part of a range of approaches and methodologies already offered by care and health networks in Brazil, provided they observe ethical principles. And on this point our concern echoes what Resolution 706 (A-23) of June 2023 of the American Medical Association stated in a recent note (REF) when it makes an extensive bibliographic review of the use of ABA. This report points to a series of harmful effects and damaging long-term consequences for adults who were subjected to the method in childhood. The ‘normalizing’ nature – in an intensive regime – of many behavioral approaches produces even more exclusion and suffering for children and adolescents with disabilities in the school context, instead of providing belonging and protagonism. We fight so that any and every method proposed as public policy must start from non-negotiable respect for the principles of the Statute of the Child and Adolescent, the Law of Guidelines and Bases of Education and the SUS.
In this direction, we must also highlight Technical Note 983781 of the National Council of Justice, regarding the proposal to adopt the ABA method. The CNJ assessed evidence on the efficacy and safety of the technology in question and concluded, in these words, that:
“The studies that evaluated the efficacy of this form of treatment are of low or very low methodological quality, being subject to numerous biases, which makes it impossible to sustain its efficacy. Moreover, the comparator in these studies was usual treatment in a public school or parental guidance, so it is not possible to establish the superiority of the ABA method over other psychopedagogical approaches, such as the therapies already offered by our health system.”(emphasis added)
Finally, we reiterate that coordination between sectors must ensure that the lives of people with disabilities and their communities thrive, and that the relationship between the fields of Education and Health is a primary partnership for these purposes, without any intention of introducing into the school the workings of a totalizing institution.
In light of the above, we call for the attention, effort and commitment of legislators, the Ministries of Education, Health, Social Development and Human Rights, secretaries of Education, Health and Human Rights, public defenders and prosecutors, teachers’ unions, associations, collectives and social movements of people with disabilities, researchers in the field of Inclusive Education, teachers and education professionals, and, notably, of President Lula, to resume the principles of the National Policy on Special Education from the Inclusive Perspective (PNEEPEI 2008), in order to strengthen and consolidate it throughout the national territory, and to contain the threats of setback and of economic exploitation of disability. This is the firm response, committed to the rights already won, that society demands.
Signed by:
Abraça (Associação Brasileira para Ação por Direitos das Pessoas Autistas)
Ambulatório de Transtorno de Aquisição de Linguagem (TAL) Fonoaudiologia / UFRJ.
Arvorecer – saúde mental de crianças, adolescentes e jovens
Associação Brasileira de Saúde Mental (ABRASME)
Associação de Surdos do Agreste Meridional de Pernambuco (ASAMPE)
Associação Internacional Maylê Sara Kali
Associação Militância Cores da Resistência / Guaranhuns
Avante – Educação e Mobilização Social
Centro Internacional de Estudos e Pesquisas sobre a Infância (CIESPI)
Coletivo Internacional Amarrações
Coletivo Ranúsia Alves da Marcha Mundial das Mulheres (Guaranhuns/ PE)
Conselho Regional de Psicologia de São Paulo ( CRP / SP)
Conselho Regional de Psicologia de Minas Gerais (CRP / MG)
Conselho Regional de Psicologia do Rio de Janeiro (CRP / RJ)
Coordenação de Assuntos Comunitário da Universidade Federal do Agreste de Pernambuco
Criola
Departamento de Terapia Ocupacional da Universidade Federal do Espírito Santo DESPATOLOGIZA – Movimento pela Despatologização da Vida
Especiais da Maré
Grupo de extensão e pesquisa “Trajetos: cotidianos e acompanhamento em saúde mental de crianças, adolescentes e sua comunidades” (UFES)
Grupo Tortura Nunca Mais
Fórum de Educação Infantil do Distrito Federal
Fórum Permanente pela Educação Inclusiva do Espírito Santo
Grupo de Estudos e pesquisas sobre avaliação, educação popular e escola pública (UFF)
Grupo de Pesquisas “Currículos cotidianos, redes educativas, imagens e sons” (UERJ)
Grupo de Pesquisas “Políticas, práticas educacionais cotidianas e o direito à Educação” (UNESA)
Grupo de Pesquisas “Subjetividades e processos de desenvolvimento dos povos amazônicos” – Faculdade de Psicologia/ Universidade Federal do Amazonas
Grupo Tortura Nunca Mais / RJ
Instituto Cáue
Instituto Paulo Freire
Instituto Viva Infância
Instituto Vladimir Herzog
Instituto Saúde Coletiva Universidade Federal da Bahia
Laboratório de Estudos e Pesquisas em Ensino e Diferença (LEPED / Unicamp)
MST – regional Agreste Meridional de Pernambuco
Movimento Surdo Agreste
Núcleo de estudos e pesquisas em inclusão (NEPI / UFMS)
Núcleo de Estudos em Educação e Diversidade (UFAL)
Rede Nacional de Pesquisas em Saúde Mental de Crianças e Adolescentes
Rede Nacional Internúcleos da Luta Antimanicomial (RENILA)
Serviço Psicologia Escolar IPUSP
UNEAFRO Brasil
Sindicato dos Psicólogos no Estado de São Paulo (SINPSI)
Trajetos (DTO/UFES)
Vidas Negras com Deficiência Importam (VNDI)
