Science in Autism Treatment: A Brief History

Applied behavior analysis and autism are an amazing couple. Over 30 years ago, a clinical psychologist spent some time at the University of Washington, the source of most of the early research on applied behavior analysis. Inspired and informed by his Washington training, the clinician went to Los Angeles and put his own spin on behavior analysis, as he started working with children whose behavioral repertoires had so many deficits of functional behavior and so many excesses of dysfunctional behavior that they were labeled autistic. He didn’t do anything new, except possibly disregard all of his education in traditional clinical psychology. All he did was apply training procedures that had been in use for many years in the basic behavior analysis research labs and procedures whose effectiveness had been well documented in peer-reviewed scientific publications.

Oh, yes, he did add one small twist to what had been done before, he had the outrageous audacity to apply those training procedures for 40 hours per week for 2 years with each child, rather than use the traditional clinical psychology talk-therapy approach of meeting with the “patient” for a 50-minute hour once a week. He then published his results in a peer-reviewed scientific journal. The results were that 50% of kids he worked with lost all traces of their autistic behaviors and the remaining 50% were also greatly improved. And thus Ivar Lovaas started the revolution in the “treatment of autism.”

But the revolution languished. Lovaas and the behavior analysts he trained as well as other behavior analysts continued to do and publish high-quality research, extending and refining his procedures. But only a small group of scientists known as behavior analysts were aware of this amazing work, perhaps the most impressive work in the field of behavior analysis.

Then, 30 years after Lovaas started his revolutionary but almost invisible research, a woman with a Ph.D. in literary criticism, or some equally irrelevant topic, had a little girl and then a little boy whose behavioral repertoires were so dysfunctional that they got the autism label. Well, after a few heart-breaking years, this mother finally found Lovaas’ behavior-analysis approach and with much work and dedication on her part and the part of the behavior technicians working with them, her children acquired typical behaviors.

And being a word woman, the Ph.D. in literary criticism then wrote what may be the most important book in the field of behavior analysis, an autobiographical case study of her two children; a non-technical case study for non-behaviorists. And being a word woman, this Ph.D. in literary criticism knew how to put the words together so as to tell her story with such warmth and such emotional impact that parents around the world are now demanding that Lovaas’ behavior-analysis training procedures be rescued from the obscurity of the previous 30 years and be used to help their own children achieve more normal lives. The word woman is Catherine Maurice; and her book is Let Me Hear Your Voice.

If there had been no Ivar Lovaas, there would be no demonstration of the real power of applied behavior analysis to completely transform people’s lives. And, if there had been no Catherine Maurice, no one would know about this power of applied behavior analysis

to completely transform people’s lives. Her book is an amazing collaboration between science and art.

Lovaas and Maurice started the revolution, but the revolution is far from over. Fortunately, some of the brightest, best trained, most hard-working researchers and practitioners in the field of behavior analysis are dedicating their lives to continuing and spreading this revolution. And many of these researchers and practitioners have joined with parents of children labeled autistic to form the Association for Science in Autism Treatment.

This association may be the next major component in the behavior-analysis/autism revolution, providing a systematic way to educate professionals and the public so they can demand behavior-analytic training programs for children labeled autistic, so that there will be enough well-trained behavior analysts to implement these programs, and so that quality-control standards will be implemented to maintain the integrity of these programs.

You can get more info on autism at1) The Association for Science in Autism Treatment athttp://www.asatonline.org2) The Association of Applied Behavior Analysis International athttp://www.abainternational.org/

A History of the Basic Practicum (PSY 3570) Program for University Students to Work with

Children with Autism

In the early 1970s, the Croyden Avenue School began providing services to students with severe multiple mental and physical handicaps. These services were provided in conjunction with the Behavioral Psychology Program at Western Michigan University. Students were taught a variety of skills, which were methodically sequenced though task analysis, written as individualized instructional procedures, and taught in a discrete trial format.

By the 1980s, Croyden was also providing services to students with autism, and a preschool program was developed a few years later. As parents of children with autism became aware of the success that Ivar Lovaas had achieved with autistic preschoolers through early intensive behavioral intervention, many began to request this type of intervention for their children. In May 1995, the Discrete Trial Classroom was developed as a half-day program with five children diagnosed with autism and five practicum students. Over the years, Croyden staff and WMU staff and students have continued the development and expansion of the Discrete Trial Classroom, which is currently a half or full day program with many children receiving behavior analytic services from practicum students and staff.

The Croyden Avenue School and now WoodsEdge Learning Center has been fortunate to have a unique working relationship with WMU for so many years. Students and WMU professors have participated at, or been affiliated with, the Croyden Avenue School from the beginning, including such notables as Mark Sundberg, Jim Partington, Ray Miltenberger, Brian Iwata, Nancy Neef, Wayne Fuqua, Neal Kent, Paul Mountjoy, and Jerry Shook.

The program still continues today and is now held at their new location at WoodsEdge Learning Center.

General Class DescriptionDescription of Setting

Kalamazoo Regional Educational Service AgencyWoodsEdge Learning Center

1501 E. Milham Ave. – Portage, MI 49002 – Phone 269.250.9400

WoodsEdge Learning Center provides instructional services for students from birth to age 26 who are severely mentally or multiply impaired. A full range of educational services is provided including academic instruction, motor development and aquatics, self-care skills, job-related instruction, language development, community-based instruction and support services. In addition, services are made available for parents to learn effective behavior management skills.

While the Kalamazoo Regional Educational Service Agency (K/RESA) uses many of the techniques and procedures outlined in this book, the K/RESA Board of Education and Michigan State Law forbid the use of corporal punishment with any of the students we serve. Therefore, K/RESA cannot support or condone the use of any aversive control technique referenced in Teaching Developmentally Disabled Children: The Me Book (by Ivar Lovaas) that produces or causes physical pain. In addition, we do not recommend or condone the use of such techniques in any environment.

In order to meet individual student needs at WoodsEdge, the Preschool Village is made up of three classrooms – the Early Childhood Developmentally Delayed (ECDD) classroom, the Group Skills classroom, and Pre-kindergarten. The ECDD classroom is available to provide one-to-one discrete trial instruction, to establish instructional control, and to develop pre-learner skills necessary for success in future learning environments. When children master pre-learner skills they can move on to group skills classrooms.

The focus of the ECDD classroom is to increase environmental awareness. This includes using eye contact, demonstrating imitation skills, and following basic directions. The students will also learn a method of communication, to better enable them to control their emotions. Instruction takes place in individual booths designed to keep distractions to a minimum. Western Michigan University (WMU) students are trained to implement individualized teaching procedures. Positive reinforcement is used to increase positive behaviors, and attempts are made to ignore behaviors that interfere with learning.

Course Prerequisites or Co-requisites for WoodsEdge Practicum (PSY 3570) Psychology 3600: Concepts and Principles of Behavior Analysis or Psychology 1400:

Introduction to Behavior Analysis or Psychology 1000 Honors Psychology 3561: Preliminary Practicum

K resa

Admittance into the WoodsEdge Practicum is contingent on satisfactory performance in PSY 3600/1400/1000H and the Preliminary Practicum.

Description of Tasks and WoodsEdge Practicum Basics In the basic practicum, undergraduate students (tutors) complete a series of training

sessions designed to introduce them to various aspects of the setting. These include medical training, policies, procedures training, and PECS (picture exchange communication system) training.

Following these training sessions, each tutor will be assigned to a child at WoodsEdge, with whom they will work for the entire semester (in most cases).

Tutors will work with their child Monday-Friday for two hours a day. The two hours of time spent at WoodsEdge each day is divided into 15-minute blocks. Tutors work through eight, 15-minute sessions each day, implementing at least 3 behavioral treatment procedures designed by ECDD classroom teachers Carmen Jonaitis and Steve Kemp, school psychologists Dr. Steve Ragotzy and Dr. Paul Knight, and WMU doctoral and masters students. The majority of these behavioral interventions are based on practices researched in applied behavior analysis and discrete trial training (DTT).

The tutors receive feedback before, during, and/or after DTT sessions from their supervisor or teaching assistant (TA).

The TAs and supervisors are graduate psychology students from Western Michigan University.

General Classroom Information

There is a lot of information to learn at the beginning of the semester, and we don’t always remember to tell you everything. Be sure to ask if you have any questions. It is equally important to make suggestions. Although we’ve been doing this for a long time, you will be the one with the closest day-to-day contact with your child, and may have valuable insight that will help your child progress more quickly. So, please let us know!

Bussing: Your job will be to pick up and/or drop off the child from the bus. Never carry your child under any circumstances.

Books & Bags: Children have their own home/school notebooks, which relay information between parents and the classroom teacher and the classroom staff. Because parents may write about sensitive topics (medications, etc.) the notebooks are confidential.

Reinforcer Bins: Each child has a bin that contains their favorite reinforcers. This may include various toys, books, etc. It is also very important that the child’s reinforcers are not placed in the material bins, and that the instructional materials are not placed in the reinforcer bins.

Material Bins: The material bins contain instructional materials that will be used by other practicum students after you leave the shift. Consequently, it is very important that all materials are returned to the bins when the procedure is done. Please keep extra materials out of the bins such as tissues or reinforcers. Please let your TA or supervisor know if any of the items from the bin are missing.

Icon Rings: Each child has a ring with laminated pictorial icons of activities that the child is scheduled to do. When getting ready to do an activitiy, say, “It is time to go to bathroom (speech, booth, etc.)”, and bring the icon to the destination. After you reach the destination, you can place the icon ring in your apron. Make sure you bring it back to the booth with you.

Booths: Each child is also assigned a booth that they will work in every day. The booth contains two chairs, an empty desk, a material bin, a box of tissues, and a waste basket. Booths should be cleaned at the end of each shift.

Data Sheets: The data sheets in the procedure book should only be marked in pencil. The classroom teachers, the classroom staff, and your TA or supervisor are the only ones who can make phase changes (phase changes will be discussed further in later readings).

Speech: Many of the children participate in Speech. During this time you should reinforce appropriate behavior such as quiet hands, good in-seat behavior, etc. and

prompt or model appropriate responding when the Speech teacher asks for your assistance. You can also help make sure your child is attending to the speech teacher, has quiet hands, etc.

Playroom: The children are scheduled to be in the playroom at specific times for procedures or structured play. Your child should not be in the playroom at any other time. Structured play is an excellent time for you to establish yourself as a reinforcer and work on appropriate play skills. You should interact with your child the entire time you are in the playroom (See Extra Learning Opportunities section in Readings #2). This is not a time to sit, relax, or socialize with your classmates. Toys should be put away before you leave.

Children: Never leave your child alone, even for a minute. If you need to use the restroom, etc., ask someone to watch your child for you. Do not take your child’s behavior personally, and do not get angry with him/her. Try to remember that he/she is a very young child and with a very serious impairment. If you need a break because you feel like you are getting angry, don’t hesitate to ask your supervisor/TA to take over for a few minutes.

Other: 1. When your child gets injured (hits his/her head, pokes his eyes, scratches a scab, etc.) or if your child looks sick, please inform your TA, supervisor, or the classroom staff. Please do so even if the injury or sickness doesn’t seem serious.

2. When you do not have to take care of your child (e.g., your child is absent, late, at occupational therapy [OT], etc.), ask your TA what you should do. It is not a time to take a rest and socialize with other practicum students.

3. There is a WoodsEdge “no-scent” policy, and be aware that some products that claim to be unscented are not. Often children are using medications or will have certain medical conditions. Because of confidentiality issues, we cannot tell you about these conditions.

4. Wash your hands before you start working with your child and before you leave WoodsEdge.

5. WoodsEdge Drills Fire Drills

o Immediately go outside no matter where you are (i.e. the booth, playroom, speech, etc.).

o Follow the group that you are with and if you are not with the class, find someone with a walkie-talkie and let them know that you are in Carmen and Steve’s class.

o This is the only time that you are allowed to pick up your student and carry them if they are tantruming and refuse to walk.

Lock Down Drillso Stop whatever activity you are doing.

o Follow the classroom teachers, staff, or TAs to an assigned area. Tornado Drills

o Classroom staff (Trista, Gretchen, and Katie) will assist you in finding the proper shelter, probably in a bathroom.