Behavior Modification -- The Lovaas Method

Behavior modification refers to techniques used to encourage certain appropriate behaviors through rewards and discourage or punish inappropriate behaviors. For example, if a college student does well in a course, he/she receives an 'A' to reward good behavior. If a person drives too fast on the street or highway, he/she may be punished by receiving a speeding ticket.

Appropriate behaviors are rewarded using positive reinforcements. These are anything which is given to increase the likelihood that the behavior will recur. Examples include praise, such as "good job;" an opportunity to play outside, and/or an edible, such as a cracker. In contrast, inappropriate behaviors can be reduced or eliminated in a number of ways. Common forms include saying the word "No," or placing the child in time-out. Time-out is where the child is removed from the possibility of obtaining reinforcement, such as having the child sit in a chair for a few minutes rather than play. Another way to reduce inappropriate behaviors is called 'extinction.' In extinction, a behavior is no longer rewarded; and as a result, the behavior is less likely to recur. If the child is not cooperating in a task, the therapist may simply turn his/her head away from the child rather than give the child unintentional attention.

Since the 1960's, Professor O. Ivar Lovaas at U.C.L.A. has developed a rather elaborate program to treat autistic children. The core of the program involves one-on-one therapy. This method is being used throughout the country, with therapy hours ranging from 15 to 40 hours (or more) a week. It is felt by many that the more hours one works with the child, the more he/she will improve. It is believed that children under 5 years of age will benefit the most from this program even though there have been some recent reports of older children also improving dramatically from this approach.

The program focuses on a number of the child's behaviors, including attention, social skills, concept formation, language, self-help skills, and appropriate play. Many of the tasks used in this method are described in The Me Book written by Dr. Lovaas in 1981. The therapist begins with very simple tasks which are rewarded, and then gradually increases the task's difficulty before rewards can be obtained. In addition, the therapist often relies on prompts, such as pointing to an object or an aspect of the object to direct the child's attention to relevant cues. These prompts are gradually faded or removed. Although learning sessions are often conducted in a clinical setting, it is important that the learning tasks also be conducted at home and in other settings to help the child generalize what he/she has learned. Certain autistic behaviors, such as self-stimulation and non-compliance, are discouraged during the teaching sessions because these behaviors interfere with learning.

Research on the Lovaas method has shown that many children do extremely well. In a 15-year study published in 1987, Lovaas found that 47% of the children who participated in his program were able to complete normal first grade classes. A recent book by Catherine Maurice titled, "Let Me Hear Your Voice," describes her child's success with this approach.

Written by:
Stephen Edelson, Ph.D.