Intensive Behavioural Therapy (Lovaas Therapy)
What is it?
Also known as Applied Behavioural Analysis (ABA), Model of Applied Behavioural Analysis or Home Based Behavioural Intervention, this therapy was devised by Ivar Lovaas, a Norwegian psychologist, who worked in the 1960's on developing verbal communication with autistic children. The Lovaas therapy is an intensive therapy which takes place at home.
The principles
The Lovaas method involves one-on-one coaching lessons with a therapist. It is based on the assumption that autistic children need to be taught everything including communication, expression and socialisation. Autistic children are said to be unable to learn how to do things by copying other human beings. With the Lovaas therapy each task is taught in a repetitive way until the child masters it completely. Children learn how to pay attention, how to copy behaviours, imitate sounds, understand what people say, play with toys, show emotions, and how to relate to other children.
Dr Lovaas believes the environment plays a key role in the recovery of autistic children. He tested his method on a group of children placed in institutions and noticed that each time the children returned to these institutions once the sessions were finished, they were losing the benefits of the therapy. He decided to set up sessions at home, this way therapists could teach the children and train their parents at the same time.
The therapy is intensive, the therapist works with a child for an average of 8 hours a day. There is a reward or verbal praise for the child if he/she carries out a task. According to Lovaas, behavioural modification takes place if the therapist or parents give positive acknowledgement to the child once he/she has performed a task. In the early days Lovaas had to face criticism from his colleagues who argued that punishment or aversive procedures had been given to children who inflicted self-injuries.
Research
Dr Lovaas's work is based on over 30 years of research in psychology. He never claimed that his method could cure autism. Results from a study he conducted in 1963 showed that the intensive behavioural therapy may help some autistic children.
20 children, aged from 5 to 12, were involved in the study. They were divided in 3 groups: the first one received 40 hours of treatment every week, the second one received 10 hours along with other therapies and the third one received no behavioural treatment at all. The results were published in 1987 and revealed for the first time the importance of behavioural therapies. The findings indicated that in the first group, 47% of the children improved dramatically since they were able to go to a mainstream school, about 40% made substantial progress but still showed autistic characteristics such as language and intellectual disabilities, finally 10% of the children made no progress at all.
Another study in 1993 was to assess whether the 9 children whose condition improved greatly still retained their gains into adolescence. Psychologists declared they could not find any difference between these children and normal children. Opponents to the therapy criticised the study arguing that children had not been selected and assigned to the various groups at random.
Recent studies showed mixed results and highlighted the difficulty in assessing the programme as the methodology used in these trials varied from Lovaas' model.
- Smith T, Buch GA, Gamby TE. Parent-directed, intensive early intervention for children with pervasive developmental disorder. Res Dev Disabil 2000 Jul;21(4).
- Mudford OC, Martin NT, Eikeseth S, Bibby P. Parent-managed behavioral treatment for preschool children with autism: some characteristics of UK programs. Res Dev Disabil 2001 May;22(3).
How much does it cost?
It is an expensive therapy (around £20,000 a year). Many local education authorities are now willing to pay for the therapy, according to the support group PEACH, if the local authority refuses to pay they have to refer the case to a tribunal where it can be challenged.
Resources
Organisations
LIFE (Lovaas Institute for Early Intervention)
Dr O.Ivar Lovaas
Los Angeles Office
11500 West Olympic Blvd, Ste 460
Los Angeles, CA 90064
USA
Tel: (001) 310 914-5433
http://www.lovaas.com
The National Autistic Society (NAS)
393 City Road.
London EC1V 1NG
Tel: 020 7833 2299
http://www.nas.org.uk/
PEACH (Parents for the Early Intervention of Autism in Children)
The Brackens
London Road
Ascot
Berkshire SL5 8BE
Tel: 01344 882248
http://www.peach.org.uk/
LEAP (London Early Autism Project)
LEAP House
699 Fulham Road
London SW8 5UJ
Tel: 020 7736 6688
http://www.londonearlyautism.com
The Autism Research Institute (ARI)
4182 Adams Avenue
San Diego
California CA 92116
USA
Tel: (001) 619 563 6840
http://www.autism.com/ari/
Publications
- Lovaas O. I. Ackerman A.B., Alexander D., Firestone P., Perkins J., Young D. (1981) Teaching developmentally disabled children: The Me book (updated in 1997) ISBN: 0 936104 78 3. Pro-ed 8700 Shoal Creek Boulevard, Austin TX 78757-6897 (USA).
- Lovaas O.I. (1977) The autistic child: Development through behavior modification. Irvington Publishers Inc., New York.
- Lovaas O. I. (1987) Behavioral treatment and normal educational and intellectual functioning in young autistic children. Journal of Consulting and Clinical Psychology, 55, 3-9. Available from the NAS.
- Lovaas O.I. & Smith T. (1989) A comprehensive behavioral theory of autistic children Journal of Behavioral Therapy and Experimental Psychiatry, 20, 17-29.
- Mc Eachin J.J, Lovaas O.I., Smith T. (1993) Long-term outcome for children with autism who received early intensive behavioral treatment. American Journal on Mental Retardation, 97, 359-372.
- Johnson C. & Crowder J. (1994) From Tragedy to Triumph. ISBN: 0828319650. The story of one of the 9 children who took part in the Lovaas study and recovered from autism.
- Maurice C. (1996) Let me hear your voice. ISBN: 0 449 90664 7. Robert Hale.London.
- Maurice C. Green G., Luce S. Behavioral intervention for young children with autism: a manual for parents and professionals. Pro-ed 8700 Shoal Creek Boulevard, Austin TX 78757-6897 (USA).
- Chance P (1987) Saving Grace. Psychology Today, 42-44.
- Temple G. (1986) Emergence: Labelled Autistic. The story of Temple Grandin who recovered from autism and holds a Ph.D in animal science.
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