All Things Considered Except – Results

Not once did the writers suggest that parents have the right – indeed an obligation – to ensure that their children are receiving the best educational programs available. Not once did they query the evidence for programs other than “Lovaas Therapy.”

“Lovaas Therapy” is the shorthand commonly used for the UCLA Young Autism Program. The UCLA project began studying methods of treating young children with severe autism in about 1965. The NPR segment suggested that it was of more recent origin and experimental by saying that the program was “introduced” in 1987. In 1987, Lovaas published “Behavioral treatment and normal educational and intellectual functioning in young autistic children.” in the Journal of Consulting and Clinical Psychology (Volume 55, pp. 3-9), a prestigious publication of the American Psychological Association. He reported that intensive behavioral-educational instruction during the preschool years was successful in eliminating the symptoms of autism in 9 of the 20 participants in his intensive training group. None of the control group children achieved that level of success. The control group children would have received other less intensive instruction or treatment.

A follow-up paper, “Long-term outcome for children with autism who received early intensive behavioral interventions.” by John J. McEachin, T. Smith and O.I. Lovaas appeared in the American Journal on Mental Retardation in 1993 (Volume 97, 359-372.) AJMR asked several experts in the field to comment on the McEachin et al. work. These experts expressed misgivings consistent with their being good scientists but each concluded that the findings had to be considered very seriously. Moreover, none of these critics were able to nominate other approaches. The presenters of “All Things Considered” probably did not know of this paper and the scrutiny it had received.

These papers document that some children in the intensive early intervention program progressed to the degree that they could not be distinguished from other average teenagers. In other words, they were no longer diagnosed as “autistic.” Although others make claims, no other program has presented comparable results.

It is difficult enough for parents and professionals working in the field of autism without respected programs such as “All Things Considered” fueling the often heated arguments between parents and their local schools.

My major concern with this segment is the clear suggestion that school officials know best – even when we know that schools often ignore the results of the best research in the field. – even when we know that the schools are offering other programs for children with autism that have NO credible research support.

The NPR program refers to “Lovaas Therapy” as an experimental technique that may not work for all autistic children.

DOES ANY TREATMENT – MEDICAL, PSYCHOLOGICAL OR OTHER – WORK WITH ALL PERSONS? Of course not. DOES THAT PREVENT US FROM FIRST USING THE BEST TREATMENT AVAILABLE? Apparently yes, when it comes to choosing educational programs.

A basic principle of behavior analysis is that each individual’s behavior is studied carefully and programs are tailored to meet particular strengths and needs. The individual’s progress is the primary guide to program changes. At the moment, this is the best approach to be taken with all children with autism. At the moment, there is no reliable basis for selecting and rejecting children for intensive intervention based on the principles and procedures developed by Lovaas and many other applied behavior analysts.

The NPR segment includes disparaging comments by Dr Eric Schopler, the founder of TEACCH. The interviewer did not ask Dr Schopler the following important questions:

“Does TEACCH offer an effective alternative?”

“Where are the results reported so that we can study them in more detail?”

Given Dr Schopler’s contributions to the field of autism, perhaps the interviewer thought such questions would be impertinent. They are, however, the very questions that must be asked and some parents are beginning to ask them. And some school officials are unable to answer them.

An attorney for a school district in Virginia criticized parents for advocating that other options are not acceptable. The interviewer did not ask:

“What are these other options?”

”What evidence supports that they are effective?”

Rather than discourage parents, NPR might have considered that the actions of these parents should be applauded. Do we wish less of responsible parents?

We should ask that school officials and their attorneys continue to ask: “What are the results of the approaches being advocated?” “Where are they published?” Persons who have good data will welcome these questions and wasteful court cases can be avoided.

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