Answer: Contact the intake coordinator at the nearest treatment headquarters with basic information such as your name, the age of your child, and where you live. The intake coordinator will send you an application and detailed information on our services. Much of that information is also available on this website under the Services page. Also, go to the Downloads page for a step-by-step guide to starting a Lovaas program.

Answer: The Lovaas Institute makes an effort to provide services to individuals throughout the United States and in some parts of Canada and Mexico. Unfortunately, we do not always have the staff available to send to distant locations. Email us atinfo@lovaas.com with basic information such as your name, the age of your child, and where you live. Should the Lovaas Institute and the Multi-Site Young Autism Project not have services in your area, you may be able to find a behavior analyst in your part the world. If you go to the Association for Applied Behavior Analysis' website, www.abainternational.org, you will be able to locate behavior analysts in other countries that may be of assistance. An additional resource would be the Behavior Analyst Certification Board at www.BACB.com. Certification is not, however, equivalent with experience in Early Intensive Behavioral Intervention nor autism in general. The Autism Special Interest Group of the Association for Behavior Analysis has assembled a list of requirements for individuals competent to direct programming (found at the ABA website above). Parents can find additional information on interviewing a service agency or behavior analyst at www.behavior.org. Finally, helpful information can be found in the 2003 intervention manual published by Dr. Lovaas found at www.proedinc.com.

Answer: Unfortunately, we do not allow visitors to observe treatment with the children we serve. First, we are cautious in maintaining the confidentiality of our clients. Second, accepting the large number of requests we receive to observe therapy would impact the quality of services a child might receive due to ongoing distractions. Finally, the above two factors are compounded by the fact that 80-90% of our clients receive treatment in their homes. To see a "snapshot" of treatment, many people end up seeking out families in their area who are receiving similar services. Autism support groups in your area may be able to refer you to appropriate contacts.

Answer: The Autism Special Interest Group of the Association for Behavior Analysis has assembled a list of requirements for individuals competent to direct programming (found at www.abainternational.org). The document is entitled, "Revised Guidelines for Consumers of Applied Behavior Analysis Services to Individuals with Autism and Related Disorders." An additional resource would be the Behavior Analyst Certification Board at www.BACB.com. Certification is not, however, equivalent with experience in Early Intensive Behavioral Intervention nor autism in general. Below is one other list of questions to ask a behavior consultant and the kinds of answers you would expect to hear.

What experience do you have in the field of Applied Behavior Analysis?

IMPORTANCE: Supervising an early intervention program is not a skill that can be taught in the classroom, let alone be mastered at a conference or in-service. A "behavior consultant" with little to no experience is like a dance instructor who doesn't really dance or a piano teacher that can barely play the piano. Because implementing a program based in Applied Behavior Analysis relies on training people to DO something and not simply understand something, there is no greater question than a person's previous experience in the field. Ask yourself, would you hire a physical fitness trainer who wasn't physically fit? Below are more detailed questions to find out how "physically fit" a behavior consultant might be.

1. How many years of experience did you have as an instructor before becoming a behavior consultant?
   Lovaas Institute personnel generally have a minimum of 2 years, full time experience as an instructor before they are considered as a candidate for consultant training. Because the therapy is complex and many faceted, it requires a high level of expertise with a significant level of training and supervision. Lovaas Institute personnel make regular clinical judgments on a minute-by-minute basis, rather than following a stale written plan. Field experience emphasizes a system which delivers high-quality decision making. Lovaas Institute personnel use complicated information and analysis to make the best choices for the short term and for the long term. These considerations bear on the child's therapy.
2. What types of children did you work with as an instructor?
   Autism is a spectrum disorder. Different children require emphasis on different skills and different techniques. Returning to the analogy, a person who knows how to dance the mambo still needs to learn how to dance the tango. Lovaas Institute personnel are active with children across the spectrum before completing training as a consultant. In this way, they are familiar with effective techniques, no matter how a child "dances."
3. Who oversaw your work as an instructor?
   Lovaas Institute personnel receive feedback on a weekly basis from qualified behavior consultants while working with clients and participating in team meetings at the Institute.
4. How were you trained to be a behavior consultant?
   The Lovaas Institute uses a pyramid training approach that has a lengthy and well-regarded history in the field of community psychology. This systematic approach allows personnel to gradually take on more responsibility as an instructor, followed by specific training and formal competencies related to a consultant's role. This training includes: passing academic tests on Applied Behavior Analysis and the Lovaas model methodology, designing and defending interventions based on observations of different children, shadowing of current behavior consultants, and responding to hypothetical situations under the guidance of other consultants and the site supervisor.
5. How many years of experience do you have and who oversees you now?
   The Lovaas Institute continues to assure quality control through oversight of all behavior consultants. Reports and programming for each child are submitted to the Institute for review. The Lovaas Institute holds meetings to discuss ongoing research affecting best practices. And, Lovaas Institute consultants participate in a private email list with other consultants, program directors, and psychologists that specialize in the treatment of children with autism throughout the world.

What is your academic background in the field of Applied Behavior Analysis?

IMPORTANCE: While experience in the field under qualified supervision is the most important factor in finding a behavior consultant, every behavior consultant should have the academic background to evaluate interventions effectively and speak intelligently not only to parents, but also to others in the field. Basic questions to ask include:

1. What's the educational background of the team providing consultation and supervision/consultation oversight?
   With the Lovaas Institute, you aren't simply assigned a behavior consultant. You receive support from a behavior therapy team. While educational background varies, typically the team includes Board Certified Behavior Analysts, higher degrees in Applied Behavior Analysis, and master's level work in psychology, education, speech-language pathology, etc.
2. What credentials or licensing does the agency hold?
   Individual certification such as the national BCBA credential is a new phenomenon in the field of Applied Behavior Analysis. For more detailed information on a company or organization, its past credentials and licensing should also be asked for.

How flexible is your approach?

IMPORTANCE: A good program based in Applied Behavior Analysis recognizes the ongoing progress made in our understanding of human behavior from published research. A good program based in Applied Behavior Analysis also recognizes the difference between theory and practice, and that no single approach is effective for everyone. The following questions can help determine how well a behavior consultant balances these issues.

1. How do you stay current with ongoing research in the field of Applied Behavior Analysis?
2. What are some examples of how what you do with most children you may not do in a particular circumstance?
3. How do you determine what the best approach to take is?
4. How do you handle situations where a family wants to include other interventions besides ABA?

Answer: Most of our positions are listed on the Employment page. In general, we have instructors who provide a child's direct behavioral intervention, working one-on-one with a child in his/her home, and case supervisors/consultants who oversee a child's intervention at the Institute or throughout the country.

Answer: The starting position of instructor offers wonderful and valuable field experience for those seeking to work with children with special needs. We strive to employ high-energy instructors who are enthusiastic and motivated to learn.

As an instructor at the Lovaas Institute, you would be responsible for providing one-to-one treatment to a child. The treatment you would provide is very structured and intensive; regardless of prior experience, all new instructors will be trained and overlapped with an experienced instructor prior to being scheduled alone. New instructors will be compensated during training.

Most instructors work two shifts per day; one in the morning, and one in the afternoon. Because most treatment hours occur in the child's home, instructors must have reliable transportation. Instructors are compensated for portions of mileage traveled and drive time between work locations.

The Lovaas Institute provides treatment to our clients Monday through Friday, and Saturdays when staff availability permits. We are often interested in hiring part-time and full-time employees with Saturday availability. No treatment is provided on Sundays. In addition to these hours, attendance at your clients' weekly one-hour clinic meeting is mandatory. Clinic meetings are designed to help your supervisors assess the child's progress, modify treatment as needed, and provide instructors with ongoing feedback and training.

The Lovaas Institute provides a benefits package to its full-time hourly employees (defined as 35 or more hours per week), which includes paid holidays, two weeks vacation per year, sick/personal leave, and medical and dental insurance. Salary is dependent upon degree and prior experience.

This position is very rewarding, but it requires dedication, dependability, and a willingness to learn. If you believe you have what it takes to succeed in this fast-paced team environment, please mail, fax, or email a cover letter and resume to the appropriate clinical treatment headquarters. Addresses can be found on the Contact Us page.

Answer: Application is the same as for those applying in the United States. See the FAQ, "Applying to the Lovaas Institute," for more information. However, all prospective employees must also have evidence of eligibility to work in the United States.

Answer: We make a distinction between three different types of training: general training, information sessions, and child-specific training.

General Training

We often receive requests from individuals and organizations asking for training in Lovaas/ABA therapy so that they can be qualified to carry out the program themselves. We do not currently provide general training outside of the Lovaas Institute. We only provide child-specific training as described on our website under clinic-based services and consultation services. We are currently in the process of reconfiguring our certification process, in an attempt to make it possible for individuals away from the Lovaas Institute to become certified in our methods. However, the process will be both detailed and lengthy. The reason for this is twofold.

First, Applied Behavior Analysis is a scientific discipline, with all the rigor of any other academic field. The professional background necessary to competently design behavior therapy for children with autism is at least as detailed as the educational background necessary for schoolteachers. Refer to the Behavior Analyst Certification Board at www.BACB.com for an example of the professional background now used as guidelines in six states.

Second, a professional background in Applied Behavior Analysis is not equivalent with experience in Early Intensive Behavioral Intervention nor autism in general. Those who implement the "Lovaas method" must learn a skill rather than just gain a set of knowledge. Research into performance-based skills has shown that training for skills such as implementing ABA procedures requires real practice with a particular individual and immediate feedback from someone already qualified in the techniques. Competent training programs in ABA all follow this typical pattern of: 1) modeling with a client by someone who has already been trained, 2) practice by those who are receiving training, and 3) feedback from the person who has already been trained. So called "training conferences" that involve lecture, videos and role-playing are of questionable help. Refer to the "Revised Guidelines for Consumers of Applied Behavior Analysis Services to Individuals with Autism and Related Disorders" found at www.abainternational.org/sub/membersvcs/sig/contactinfo/Autism.asp for an example of the breadth of both knowledge and experience needed to competently implement behavioral therapy.

In terms of our current training protocol, the Lovaas Institute uses a pyramid training approach that has a lengthy and well-regarded history in the field of community psychology. In short, those who are interested in gaining experience and competence in our program send an application for employment to the Lovaas Institute. At the Lovaas Institute, employees first gain valuable field experience by providing one-to-one treatment to a child with autism. Training is overseen by qualified consultants at the Lovaas Institute. Employees have the opportunity to progress to different levels of supervision in which they begin to train others in the techniques they have learned, oversee a child's progress, and eventually design programs for a child. Not all employees progress to these levels as strict performance criteria must be met in order for someone to be considered competent at each level. In all, it typically takes a minimum of two years before someone reaches a level at which they begin to learn to design programs for other children under close supervision of trained professionals at the Institute. The amount of time required to master each level again points to the complexity of a good behavior therapy program.

Information Sessions

On occasion, we provide information sessions to groups seeking to better understand the methods utilized at the Lovaas Institute. In general, information sessions are conferences given throughout the country to parent groups, school staff, and at national conferences that highlight areas of interest to that group. We have provided information sessions on topics as general as reinforcement, discrete trial teaching, incidental teaching, etc., as well as more specific topics such as ABA's Usefulness to a School Aide, Similarities and Differences of Current Behavior Interventions, etc. Informative talks can include Powerpoint presentations, video examples, role play, and/or a period of questions and answers.

While we do at times set up our own conferences throughout the country, typically, we provide information sessions to those who contact us directly so that we can tailor a talk to the group's specific needs. Whether or not we can offer such services at any given time is related to the extent of the services that are requested and the availability of qualified staff to present.

Child-Specific Training

Child-specific training is part of the consultation services we provide throughout the country to set up an individualized program for a child with autism. Those receiving consultation services are provided a Lovaas Institute behavior/program consultant who designs a program and trains instructors to work with one particular child. Training and program development occur during an initial consultation and continue over follow-up consultations.

During a 3-day initial consultation, a behavior/program consultant travels to the home or school program and teaches instructors how to begin a child's treatment. The consultation provides instruction on teaching procedures, what to teach, when to teach, how to keep records, how to supervise staff, and how to analyze problems in the child's learning. The majority of the time is spent working directly with the child. Initially the behavior consultant will model teaching procedures for the parents and staff working directly with the child, and then help the parents and staff practice these procedures with the child. Follow-up consultations are conducted on a regular basis, typically every 4-6 weeks. In order to maintain the highest quality of treatment, the recommended length for follow-up consultations is typically 6 hours (1 full day). During these follow-ups, a consultant will re-evaluate the child's program, design new goals, discuss and rectify problems, and conduct further training of parents and staff.

Answer: Between 1985 and 2000, there were over 500 articles published concerning Applied Behavior Analysis and autism. More recently, the July/August 2005 issue of the Journal of Research and Developmental Disabilities features a study demonstrating that intensive ABA therapy is significantly more effective than an eclectic, special education approach that uses a variety of techniques. This is the second study of its kind to compare two specific treatments while controlling for variables such as treatment intensity so that students in both groups received the same number of hours of therapy. Finally, Dr. Glen Sallows from the Wisconsin Early Autism Project has recently published outcome data in the November 2005 issue of the American Journal of Mental Retardation for the long anticipated follow-up replication of Dr. Lovaas' original study.

Answer: Since there are over 2000 publications in the field of autism, the National Research Council assembled a team of well-respected individuals in the field of autism treatment for that resource. You can find it online at http://books.nap.edu/books/0309072697/html/index.php. This report was commissioned by the US Department of Education and you will see in the Executive Summary that they advocate for a minimum of 25 hours per week of early intervention for all children with Autistic Disorder, Asperger Syndrome, and PDD-NOS.

Additionally, the U.S. Surgeon General states that "thirty years of research has demonstrated the efficacy of applied behavioral methods in reducing inappropriate behavior and in increasing communication, learning, and appropriate social behavior. A well-designed study of a psychosocial intervention was carried out by Lovaas and colleagues (Lovaas, 1987; McEachin et al., 1993). Nineteen children with autism were treated intensively with behavior therapy for 2 years and compared with two control groups. Follow-up of the experimental group in first grade, in late childhood, and in adolescence found that nearly half the experimental group but almost none of the children in the matched control group were able to participate in regular schooling. A review of other comprehensive, center-based programs has been conducted, focusing on elements considered critical to school-based programs, including minimum hours of service and necessary curricular components (Dawson & Osterling, 1997)." The report is available at www.surgeongeneral.gov/library/mentalhealth/chapter3/sec6.php#autism

Answer: To date no one has replicated the findings of the 1987 study without treatment intensity approaching 40 hours per week of structured intervention. From a meta-analysis presented by Sigmund Eldevik at the Association for Behavior Analysis, a clear dose-response relationship emerged between the number of weekly hours of structured intervention and performance on standardized cognitive assessments after two years of clinic-directed behavioral treatment.

Answer: Here's the short answer: Yes, we use errorless learning. Here's the longer answer: You can use errorless learning techniques and still use "no" as a consequence.

How the Discussion is Typically Framed

The term "errorless learning" has taken on a life of its own in the past few years. The term is often used when comparing the following two teaching styles.

Teaching Style 1 (no-no-prompt): A child is asked to touch a cup. The child touches a ball instead. The instructor says, "no." The child is told to touch the cup again. The child touches a car instead and again is told, "no." The child is told to touch the cup a third time. The instructor immediately guides the child to touch the cup and then rewards him.

Teaching Style 2: A child is asked to touch a cup. The child touches a ball instead. The child is again asked to touch the cup. The instructor immediately guides the child to touch the cup and then rewards him.

The question is, which of these two teaching styles is better? The answer: neither! In fact, neither teaching style is a good example of errorless learning. We'll return to these examples at the end. But first, a little background on errorless learning from the research.

What is Errorless Learning? A Short History. (adapted from a talk by Dr. Eric Larsson, LIFE Midwest)

Errorless learning is a concept originating from Errorless Discrimination which was first studied in the early 60's (See Terrace 1963, and about a dozen follow-up studies). The early work was done with pigeons who are capable of making fine visual (color) discriminations.

Typically when an organism learns a discrimination, they make some mistakes (i.e., when learning to touch a train, a child will sometimes touch another object on the floor with the train). Early learning theorists were impressed with the fact that incorrect responses were sometimes accompanied by emotional responses. For example, pigeons would flap and carry on after mistakes especially if the mistakes were followed by long time outs or aversive stimulation. These emotional responses were a concern and people like Terrace, from Columbia University, were interested in ascertaining whether an organism could learn a discrimination without making any or many mistakes, and in so doing eliminate the dissonance associated with mistakes.

The errorless discrimination and learning is usually accomplished by having the correct response be a condition that the person will readily respond appropriately to, and the wrong response something that the person will not respond to. Terrace's successful response condition was with the chamber light on and the incorrect response was with all lights off. A pigeon will freeze in place with the lights off since its night vision is terrible. Gradually bringing the lights up in the S-delta condition and increasing the duration of the condition, allowing some mistakes but minimizing them, resulted in very few responses to the S-Delta (mistakes). As I remember there was only one study showing a discrimination accomplished with no mistakes.

Applications with humans involve making the correct answer very easy to make and the wrong answer very difficult to make. Errorless learning is best used in conditions where mistakes are really a bad thing to happen. Some military applications have used it where radar screen readers are given a really obvious moving target to track and gradually the "noise" of all the other stuff on the screen is faded in to full strength. In work we do with really anxious children with autism, we try to minimize errors since they are sometimes accompanied with self injury or outrageous behavior that we like to avoid.

Errorless learning is often a mistakenly applied term to good shaping. Vargas, B.F. Skinner's daughter, did some great creative writing studies with school-aged kids and simply reinforced any good stuff in the "essays" that they wrote. With repeated trials, the kids acquired good writing skills (e.g., use of adjectives and adverbs) without ever being given negative feedback. That is not errorless, but it is good positive shaping.

Back to the Original Discussion

The discussion at conferences is often misleading for a number of reasons.

First, there is no such thing as a strict "no-no-prompt" procedure. At least, the Lovaas Institute has never employed it and has yet to find another organization that implements such a procedure. The use of a hypothetical, strict "no-no-prompt" procedure as a counterexample to errorless learning is deceptive because it is not a fair representation of a true teaching style.

Second, Teaching Style 2 is not a good example of errorless learning either. As written, the child would only be correct 50% of the time. That's still a lot of errors. Teaching Style 2 is misleading because it is only one portion of a teaching style that does not include "no" as a consequence.

What the Lovaas Institute Recommends

The Lovaas Institute, and all good behavioral treatment programs, recommend the following procedures:

• A child's response should be shaped/prompted often enough so that he/she remains successful at least 80% of the time. This typically means every response is prompted in the beginning and prompts are gradually faded. Further, on any particular day that a child demonstrates difficulty with a skill, the instructor will use his/her clinical judgment to prompt frequently enough to keep the child successful at least 80% of the time.
• Using highly dissimilar distracters in the beginning is an effective way to keep a child successful; similar items should gradually be included. Initial items will often be different in terms of physical appearance (a car vs. a spoon NOT a car vs. a train), sound (saying "cup" vs. saying "Elmo" NOT saying "cup" vs. saying "car"), function ("shoe" vs. "truck" NOT "shoe" vs. "sock"), proximity ("touch head" vs. "touch foot" NOT "touch head" vs. "touch nose"), and/or action ("stand up" vs. "knock" NOT "stand up" vs. "turn around").

The Lovaas Institute and other behavioral treatment programs sometimes differ in terms of what they do on the rare occurrence (e.g. 20% of the time or less) when a child does not respond correctly.

• Some ABA programs recommend that when a child is incorrect, the instruction should immediately be repeated (and the response almost always prompted). No other consequence should be given. Note that the child HAS BEEN incorrect and there IS a consequence (no reinforcement is delivered and the instruction is repeated)
• The Lovaas Institute recommends that for the vast majority of children, verbal feedback for an incorrect response should be given in the form of simply saying "no." The instruction should be repeated and either a) prompt the child if you are not 80-100% certain the child will respond correctly the second time or b) allow the child additional chances to answer on his/her own. Most teaching styles that include "no" as a consequence do have some other general guidelines, and one of these guidelines has sometimes been referred to as a "no-no-prompt" procedure. However, in laymen's terms, the guideline states, "If a child responds incorrectly and you are 80-100% certain that he can respond correctly, (because he has already demonstrated the skill often), you can deliver the SD again without a prompt; however, it's best to only give him one more chance to respond correctly without a prompt; otherwise, he may become too unsuccessful." Note that this is really a guideline that emphasizes errorless learning. Emphasis is placed on the fact that, 1) the child (both in the past and during the current teaching situation) should already be demonstrating a high likelihood of responding correctly on his own and 2) even if you think the child should respond correctly, don't allow many unprompted opportunities since these can lead to failure.

Frankly, in most tasks, if a child learns what response is incorrect, they learn the task more quickly. For example, by telling a child "no" when he touches the ball instead of the train, you give the child another piece of information in terms of how he responded. By calling attention to an incorrect response, on the rare occasion that it occurs, a child is given a chance to learn from his mistakes.

In Summary

The emphasis on errorless learning is nothing new in intensive behavioral treatment for children with autism. When children become frustrated, it is most likely related to an instructor not prompting frequently enough or using similar distracters too quickly rather than a result of whether the program uses "no" as a consequence.

Answer: Following is a list of strategies that were compiled informally while talking to a variety of consultants throughout the country. While each strategy, or a combination of strategies, has been successful in teaching at least one child with autism to receptively identify objects or pictures, they are not guaranteed to work with any child in particular. Further, many of the strategies give a bare bones synopsis of a detailed intervention that was designed by a competent behavior consultant. Please understand that these ideas are meant to help you brainstorm about your particular situation and that they should be shared with all of the professionals involved in your particular case so that the best possible solution can be designed for your child.

Strategies used for Receptive Labels

• Two Item Field
  Two items out, randomly ask for one
• Quick Shift Method
  Conduct massed trials for one item, give little (and no verbal) reinforcement on last trial followed by switching to the other item.
• Collapsing Programs
  Conduct massed trials for one item near the beginning, the other item near the end of the session. Gradually practice the objects with less of a time interval between them.
• Visual Distractors
  Place out 3-6 novel items. We sometimes put both target items in the field and sometimes put only one target item out.
• Voice prompts
  SHOOOOOOOOOOOOOOE, vs. BLOCK
• Singing prompts
  Similar to a voice prompt, but we sang the labels. "Fire engine" was said to the beginning of the tune "London Bridges." The SD for blanket was "blanket, blanket" sung to the tune of "twinkle, twinkle" (as in, Twinkle, Twinkle, Little Star.) Sometimes, we try to begin with songs that are linked to the object. For example, one of the items is a "Vegi Tale" named Larry the Cucumber, and the label "Larry" is sung to part of a Vegi Tale song.
• Sound Discrimination
  Say "rattle" while shaking a rattle. Child shakes identical rattle. Fade showing the rattle. Then fade shaking the rattle while continuing to say "rattle."
• Time Expansion
  Ask a label, ask it 5 seconds later, then 15 seconds, then 30 seconds, then a minute, etc. until it is expanded over an hour or a day. Then introduce a new label.
• Written Word Prompts
  Say "shoe" while showing a word card that says "shoe" and then fading the card.
• Verb-Noun Words
  Mix an action word with the label (e.g., push car, pound hammer)
• Intersperse Receptive Instructions
  E.g. clap, wave, push car, jump, shoe, etc.
• Include Sign Language/Gesture Prompts
  Say the word and make the sign for the word at the same time.
• Embed Labels in Functional Receptive Instructions
  A variation of Verb-Noun Words and Sign Language/Gesture Prompts. Deliver an instructions such as "Turn on the TV" while pointing to the TV or "Put this in the trash" while handing a piece of trash. After teaching 5-10 instructions, fade the extra prompts and then vary the words in the SD (e.g., say "turn on the TV" but don't point; later ask, "where's the TV?")
• Expressive Program
  Skip receptive, teach expressive (either verbal or written word) and then go back to receptive (linking to previously learned response.) SD "What is it?" R: Shoe. Followed by: SD "Touch shoe."
• Requesting Program
  Can be a very successful means of teaching a child the names of objects because the words are functional in that the child is requesting for items of interest. Response can be spoken, written, picture, or sign language. Difficulty may arise if child does not demonstrate enough interest in the objects, decreasing the number of opportunities to learn the correct response. Also, difficulties can arise when moving to receptive language in that the receptive response is no longer a function of requesting for a preferred item.