Myomancy ADHD, Dyslexia and Autism

Teaching Individuals With Developmental Delays: Basic Intervention Techniques

O. Ivar Lovaas

$53.19 via Amazon

People who have brought this book wrote:

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.

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