Friday, May 9. 2008

Applied Behavior Analysis and Autism in the News

Posted under: School

I seldom see a newspaper article about a child learning to read through the use of phonics. I guess that’s not surprising. Most people know that phonics is an effective method to teach someone to read. There’s nothing that makes it especially interesting enough to make the news. As Autism Awareness month ends, I noticed that I seldom saw newspaper articles about children with autism learning new skills through behavioral treatment. Most articles or TV coverage I saw focused on the latest medication, diet, or novel intervention that has made a big difference in one child’s life. Again, I guess that’s not surprising.

Behavioral treatment did receive some attention in the late 80’s and early 90’s. It’s been around for a while though, and a novel intervention that leads to spectacular results with one particular child makes for a better news story. Don’t get me wrong. It’s worth following up on those anecdotes with solid research; what works with one child may work with others. But news can be misleading, because what makes good news does not always make for good research.

Ironically, behavioral treatment suffers from the fact that it has worked so well. It is the “same old story.” In literally hundreds of research studies in peer reviewed journals, behavioral treatment has worked over and over again to help individuals with autism learn new skills. Unfortunately, many families and educators have still never heard of ABA as an effective treatment for autism. Please share your story with us here so that we can spread the news.

By Vince LaMarca, M.A., BCBA, Editor
Lovaas Institute - Indianapolis


As a mother of who have 2 boys on the spectrum, my youngest with almost no "signs" of autism today, I would say there are very good reasons why behavioral treatment(s) is not forefront in the news. It is also extremely important for parents, therapists, teachers, etc. to know that while many children may have benefitted from behavioral therapy there ARE many people who do not. Both my boys had negative reactions to behavioral therapy (my youngest started banging his head on our toilet during one session and years later sat crying on the toilet because he physically couldn't go to the bathroom at that time and wanted his reinforcer so bad that he sat there hysterical); my oldest became so prompt dependent, rote, and robotic in both actions and speech which all but disappeared once we changed to a developmental approach. My point is this, behavioral therapies may work extremely well for some kids and when and if that's the case, that's a GREAT thing! However, I'm at the point that I want to scream when someone like myself sais that it doesn't work for a lot of kids and that these techniques CAN have a negative affect. I hope someday we can have an honest discussion about how we treat those on the spectrum and truly hear their voices instead of just each others.

I'm glad to hear your sons did so well with a developmental approach. I hope you find our blog to be an honest discussion of issues surrounding applied behavior analysis and autism in general. Our hope is to provide a place where people's differing experiences can be heard and discussed openly. With that in mind, in my experience, one of my greatest reasons for supporting the Lovaas Model of Applied Behavior Analysis is that it is based on research…research that shows it does NOT work with every child with autism. Science is just as much about what can be disproved as it is about what can be proved. Take the 1987 Lovaas study. Everyone talks about the 47% of children who were in the best outcome group. Few people mention that Dr. Lovaas himself indicated the treatment was not effective for 10% of the children, at least based on the measures they used. Another support for applied behavior analysis in that in my experience, behavior analysts are willing to learn from the research and experiences of others. What did Dr. Lovaas and his colleagues do when he found his treatment was not effective for everyone? He started looking into why, and tried to make it more effective. His efforts lead to developments such as the Reading and Writing program for children who remain nonverbal. The fact that there is a spectrum to autism makes it highly unlikely that one approach will work for everyone. But, what I think ABA accomplishes better than any other approach, is allowing the techniques and procedures to be held up for critical review (in peer-reviewed research, in the data that is collected during behavioral treatment, etc.). As behavior analysts, we are constantly reassessing which procedures or approaches will work best for which children.

My son was gone, completely gone. He did not recognize me and did not care at all about his surroudings. He did not care if his intestine was completely blocked. My first concern was to give him a tool to tell me when it hurt. Our Lovaas team did that. I do not care one bit if they used ABA, which they did and other techniques, which they did too. They got my son back to me. At first it was only a little bit of language, then it was potty training, then it was controlling his repetitive behaviors, later it was figuring out that 1 and 1 makes 2, now we are discussing (yes, we are having disussions) about what is OK and not in a social environment. So people, Moms, Dads, educators, doctors and anyone who cares: we did not used to know much about Autism, but now with the numerous cases, we know some basics that apply to a great number of children. ABA or any other single therapy alone will not fix Autism, but we do know now that a well rounded program targeting the child's core issues (instestinal, chemical imbalances, alergies etc) as well as its symptoms (lack of language and comprehension, social deficiencies, awareness, behaviors, physical issues etc) and which includes both medical and non medical interventions help children with Autism improve. Over the years, we have created a program which has evolved with our son's progress. But one constant has been our Lovaas team whose techniques have also evolved with our son's changing needs. A key success factor for us has been our team who has expertise, a track record and a willingness to adapt to our child. They have designed intervention programs for so many different issues. They used not only ABA but their experience, their common sense and I must say often they had to experiment. But the engagement of these amazing individuals, their resolution to never give up or let mainstream educators stifle them has led my son to near recovery; a result that was simply unimaginable to me a few years ago. As a result, our son is entering the 3rd grade, reading, counting, writing and story telling. He is now completely verbal. We are now tweaking his behavioral issues and we are predicting loosing his diagnosis in the next year or so.

I am a mother of 3 children, one of whom is on the spectrum and until we began ABA therapy he was a child entirely in the dark. 99% of his language was echolalic, his eye contact was virtually non existant, his social skills at the age of 2 1/2 was akin to an 8 month old... i could go on and on about all the delays he had. we spent 2 years undergoing intensive ABA (35 hours a week) and it proved itself miraculous. ABA (with Lovaas) turned the light on inside our son. when we look back on pictures of our son pre-therapy we see a blankness behind his eyes. it was like having a beautiful face to look at every day but so little on the inside. our son had to be taught everything, almost like a computer that needs programing or rewiring, but his efforts proved worthwile. more than was lifesaving! today our son is 6 1/2, four and a half years past his initial diagnosis and he is a wonder child! he brings us so much joy to see him interact with his peers and genuinely seek out relationships. our son is no longer in a special ed classroom and he receives almost no therapy (i have to fight fight fight with the regional center to get even the most basic therapy to help him with any smaller issues that arise). He is a work in progress just like our other 2 kids who are "typical."

when people meet our son and learn of his diagnosis, without fail they ask, "are you sure he's Autistic?!?" i answer yes, but i am always glowing! he is an amazing child but i know entirely he would not be the warm, loving, sensitive, oh so talkative, basketball playing, math wizard that he is! i spout endless praise for ABA therapy and more specifically for Lovaas. while therapy was often trying for our son and trying for us as parents (it's hard to see your son cry himself to the point of exhaustion just because he doesn't want to follow a one step command!), the payout has been enormous.
we are confident that we chose the correct therapeutic path for our son...the proof is in our son!

Thanks for this post!

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