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Rating: 
Summary: long awaited sequel
Review: Dr. Lovaas has published the long awaited sequel to earler works (e.g., the ME Book). Students of Applied Behavior Analysis will be interested to watch the development of programmatic ideas over the decades. While many people have proposed and practice variations on the ideas (e.g., NET vs. DTT, etc.), there is no arguing with the success of the Lovaas programs. The onus is on the persons who deviate to show, in a solid data-based manner, that their methodologies can have the same success. The chapters on legal issues and answering the objections (and distortions) of the famous 1987 study are alone worth the price of the book.
Rating: 
Summary: 23 years later ....
Review: Judging by this book, the Lovaas approach has apparently only been minimally altered since "The ME Book" was published in 1981. The shouting and slapping are gone, forced eye contact drills have been dropped, a reading and writing program and a chapter on PECS have been added, various small modifications have been made, and the language is much more "touchy-feely" and "positive" (in contrast to the frankly coercive tone of the "ME Book") . But the core program is largely the same, from its start with physical manipulating the child to get them to sit down on cue, to proceeding through months of rote drills before venturing anywhere near functional communication (let alone choice or spontaneity).When it comes to its depiction of the scientific evidence, the book is deeply disingenuous; for example, Lovaas is happy to cite evidence from small-group studies when it supports his claims, but ignore it as "not scientific" whenever it conflicts with his opinions. He continually cites his own 1987 study as supporting his methods, without acknowledging that the variable studied was hours of one-to-one teaching - not teaching methodology. He cites papers he co-wrote with Robert Koegel when they support his opinions, then labels Koegel as an unscientific quack for daring to question the supreme effectiveness of discrete trials, or suggesting that motivation and functional communication might have a pivotal role in learning. His claims that techniques such as the natural language paradigm are "not supported by objective data" border on outright dishonesty, given the significant number of studies indicating that such techniques may strongly outperform Lovaas-style discrete-trial centred techniques for teaching communication. He goes out of his way to try to discredit TEACCH as useless - then includes a segment on the value of "visual schedules" (pioneered by TEACCH). He happily accepts the (limited but promising) empirical evidence for the effectiveness of PECS, since it can be incorporated into his program, but willfully ignores equal amounts of empirical evidence for techniques which don't fit so neatly into his ideology, or which contradict it. He ignores what the PECS data itself implies - that children do not in fact have to spend months doing imitation drills, or even be able to sit down on demand, before they can develop functional communication. And, needless to say, he completely ignores the large number of first-person accounts by people with autism which are now widely available (ironic that it's people with autism who are accused of failing to pay attention or respond appropriately to others ...) In some instances, he even seems determined to ignore his own data: for example, he acknowledges that "self-stimulatory" behaviour is actually functional and likely to recur in a different form if suppressed - then makes one of the earliest drills a "Hands Quiet" command, with the child's hands forcibly restrained should s/he commit the fearful sin of hand-flapping. He acknowledges that a child may be sitting passively and looking at the teacher while not actually paying attention at all, and that they may find this stressful and unpleasant to begin with - but begins with it anyway. Evidently the ideology of "Adult As Boss", "compliance", and "acting normally" over-rides data and common sense. The point that such drills may contribute to making the teaching situation highly aversive (and be entirely counter-productive in behavioural terms) seems to have escaped him. Parents and professionals should be aware that, although there is strong evidence supporting the benefits of intensive one-to-one teaching, and of techniques from the broader field of applied behavioural analysis, there is little or no evidence to suggest that Lovaas's particular teaching protocol is possessed of any special magic. However, there is significant evidence that it may be markedly less effective than more modern techniques when it comes to developing motivation and functional communication. Discrete trial teaching has its uses, especially when it comes to specific skills which can be learnt in a rote manner (for example, using words to label pictures - as opposed to using words to make requests or initiate interaction), and this is a good enough guide to that. But more broadly, the book seems to prove the axiom that when all someone has is a hammer, everything looks like a nail. In a quarter of a century, the toolkit of methods for educating children with autism has expanded to include far more sophisticated and subtle tools than discrete trials alone. But you wouldn't know it from this book.
Rating:
Summary: How Children with Autism Learn
Review: This review originally appeared in the CT FEAT Newsletter, Fall/Winter 2004, available on-line at www.ctfeat.org.
(Reviewed by Grace Conroy)
Ivar Lovaas, a professor of psychology at the University of California at Los Angeles (UCLA) and director of the Lovaas Institute for Early Intervention (LIFE), is widely regarded as the father of behavioral treatment for autism spectrum disorders. For over 40 years, he and his colleagues have been conducting research designed to develop an optimal autism treatment protocol.
This book provides a theoretical overview of "Lovaas" style treatment (as it is popularly referred to), as well as a detailed description of its teaching techniques and goals.
Lovaas departs from a lot of the mainstream thinking about "autism" in his refusal to attach much importance to the various categorical "labels" (e.g. "autistic disorder," "PDD-NOS," "Asperger syndrome"). Likewise, he is fairly scornful of efforts to articulate some sort of comprehensive "theory" to explain autism. Over the course of his long career, Lovaas has witnessed how frequently these labels and theories get revised and how little they have contributed to the development of effective treatment approaches.
Lovaas finds it much more constructive to view autism spectrum disorders as involving "developmental delays." The number and relative severity of these delays varies enormously across the autism spectrum - from the comparatively mild delays found in Asperger syndrome to the more severe problems experienced by a nonverbal child with autistic disorder. Regardless of the specific label, these children typically exhibit behavioral excesses (e.g. self-stimulation, repetitiveness) and deficits (e.g. imitation, motivation, attention) that, if untreated, completely derail the development of normal social and learning behaviors.
While Lovaas' focus is on providing parents with the tools to set up an intensive (30-40 hour) home-based treatment program, his book should be of interest to anyone wanting a better understanding of how children with autism learn. Even if you are pursuing a different kind of ABA treatment program (e.g. center-based, school-based, or for an older or less impaired child), you'll probably find it very worthwhile to read Lovaas' insightful analysis of the various behavior problems commonly associated with autism spectrum disorders (e.g. motivation, attention, self-stimulation, tantrums) .
Lovaas' approach has been extremely effective for many children, especially those he describes as "auditory" learners. Like most children with autism related disorders, "auditory learners" have tremendous difficulties with language and communication. But with early and intensive behavioral treatment, they demonstrate a relatively rapid ability to acquire verbal imitation and expressive language. These skills provide the foundation for teaching an enormous range of other behaviors necessary for developing more "normal" degrees of social relatedness and learning. With intensive treatment, a significant percentage of this subgroup can attain fully "normal" levels of functioning in every domain.
Only about half of the children diagnosed with autistic disorder meet this profile. Other so-called "visual" learners may benefit from a communication program developed by, Nina Lovaas (Ivar's spouse) and her colleagues called "The Reading and Writing Program" (R&W). In a section devoted to "strategies for visual learners," there is a chapter describing the R&W program, as well as a chapter on the Picture Exchange Communication System (PECS) developed by Andy Bondy and Lori Frost.
The first four sections of the book are authored by Lovaas: "Basic Concepts," "Transition into Treatment," Early Learning Concepts," and "Expressive Language." Most of the chapters in the three remaining sections ("Strategies for Visual Learners," "Programmatic Considerations," and "Organizational and Legal Issues") are written by various collaborators, including Tristram Smith, Jacqueline Wynn, Andrew Bondy, Lori Frost, Nina Lovaas, Svein Eikeseth, and Attorneys Gary Mayerson and Kathryn Dobel.
Lovaas considers this to be a "basic" manual and has plans to publish a second volume of "advanced" programs focused on more sophisticated skills. But if your child is ready for more challenging material, don't wait for that book. At least in my experience, parents who have fully absorbed the extensive theoretical and technical information presented in this book will have the foundation for devising whatever more advanced programs their child may need.ยค
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