My "Thoughts On Dr. Ivar Lovaas from a Parent" in the ASAT Tribute to Dr. Ivar Lovaas; Fall 2010 Issue of Science in Autism Treatment

Harold L Doherty:  I was honored to be able to submit  a commentary  titled "Thoughts on Dr. Ivar Lovaas from a Parent" in the Association for Science in Autism Treatment Fall 2010 Issue of Science in Autism Treatment - Celiberti D., Taylor, B. (2010). A Tribute to Dr. Ivar Lovaas. Science in Autism Treatment,7(4), 8-11. Science inAutism Treatment,71(4), 8-11.

Tribute to Dr. Ivaar Lovaas

The following series of tributes appeared in the Fall 2010 issue of Science in Autism Treatment.

Bridget Taylor, PsyD, BCBA-D and David Celiberti, PhD, BCBA-D
When on August 2nd, Dr. Ivar Lovaas passed away, the field of autism treatment and behavior analysis suffered a significant loss. Dr. Lovaas began his career when the psychoanalytic theory of autism was presumed valid, despite a grievous lack of supporting research. Flouting that unsubstantiated conventional wisdom, Dr. Lovaas changed the course of autism treatment by initiating a long-term program of targeted research. That research led to his seminal 1987 study, demonstrating that some children with autism can make significant progress with early intensive behavioral intervention. This indispensable work paved the way for additional empirical demonstrations and single-case subject designed studies, all supporting the central premise that, with behavioral intervention, children with autism can overcome many of the debilitating effects of the disorder and learn skills previously considered unattainable.

Dr. Lovaas‘s practical manual, The Me Book, was one of the first volumes to put validated interventions directly into the hands of parents and practitioners. The Me Book charted a new course of treatment, and offered parents and teachers a road map of what — and how — to teach. It is an understatement to say that Dr. Lovaas was a pioneer. And while his work may have generated controversy and criticism, few great thinkers have followed such a visionary path without suffering detractors along the way. Today, thousands of children and families — whether or not they realize it — enjoy the benefits of the programs and strategies that Dr. Lovaas advocated. His work will continue, and his legacy will not be forgotten. As part of this tribute, Josh Pritchard and Allyson Ross have interviewed Tris Smith who speaks of his involvement with Ivar, as well as thoughts from a parent who was deeply impacted despite never meeting Dr. Lovaas. That interview can be found here. In addition, Harold Doherty has provided a father’s perspective on Dr. Lovaas, his passing, and his contributions to the field.

Interview with a Board Member:  Tristram Smith by Josh Pritchard, MS BCBA & Allyson Ross, BS

We chose, in this issue, to interview board member Tris Smith, as he worked closely with, and knew well, the late Dr. Ivar Lovaas. We have the great fortune to have Tris‘s contributions to ASAT through his active role on our board. We hope you enjoy this brief insight into Tristram‘s life and history.

Q: Before we get into questions about your ―”job” what kinds of things do you do outside of work, for fun?

Answer: I‘m mostly a home-body, spending time with my wife and 7-year-old daughter. My 18-year-old son recently started college. When I have spare time, I like to create family photo albums and scrapbooks, cook, read general science books, go for hikes, play chess, or collect ancient (but inexpensive) coins.

Q: How would you characterize ―”what you do” to people that ask? If you were to give a ―”30-second elevator explanation” of your job.. what would it be?

Answer: I work with children with autism and their families. My work involves providing applied behavior analytic (ABA) intervention, consulting to community providers, and conducting research to test ABA and other treatments.

Q: How did you first get involved with autism?

Answer: When I was in college, I had an opportunity to become a buddy for an adult with autism. He was a brilliant man in many ways. For example, he liked reading dictionaries, and he could always stump me with spelling or vocabulary words I had never heard of. He also routinely trounced me in checkers without even looking at the board or taking much time to think. However, he couldn’t hold down a job, had no friends, and lived in a supported care facility. This mix of extraordinary skills and challenges was fascinating and touching to me, and it sparked a lifelong interest in searching for ways to help individuals with autism.

Q: What is your goal in your work with ASAT? How does it fit with your personal goals and interests?

Answer: My goal is to ensure that ASAT‘s website and publications present accessible, up-to-date, and accurate information about research on interventions for individuals with autism spectrum disorders. This activity helps keep me from getting so caught up in my own research that I lose track of what else is going on.

Q: How did you first hear about/ interact with ASAT to get involved?

Answer: Accepting an invitation from Catherine Maurice and Gina Green, I gave a talk at a conference in Pittsburgh in 1998, when the initial efforts to form ASAT were underway. I had contact on and off again with ASAT until I joined the Board of Directors in late 2005 or early 2006.

Q: What, exactly, is/are your role(s) with ASAT?

Answer: I‘m the Chair of the Scientific Review Committee, which reviews scientific research on autism treatments, works with other ASAT committees to disseminate research findings, and consults to ASAT members on scientific issues such as interpreting the validity of news items about autism treatment.

Q: What was it like to work with Dr. Lovaas?

Answer: It was exhilarating. My first year of graduate school was the final year of data collection for Lovaas‘s now famous 1987 study. For my master‘s thesis, I scored the pretreatment videos, and I could scarcely believe my eyes when I saw how much some of the children had improved from these videos to the time I met them. I also had the extraordinary opportunity to witness these kinds of improvements firsthand as a one-on-one student therapist for a couple of the last children to enter the study under the direct supervision of Lovaas himself, and his superb team of more senior therapists and graduate students. Lovaas was inspirational— exuberant, outgoing, brimming with excitement about his work, teeming with ideas for new research projects, and always keen to sit down to work with a child with autism. He also was enormously generous. For example, he kept me on the payroll during an illness that otherwise would have required me to go on disability. He supported Annette Groen, Jacquie Wynn, and me as we conducted an outcome study in his clinic, diverting resources that he easily could have used for his own work. He went far out of his way to credit me and other graduate students for our contributions and to help us find jobs when we left.

Q: Wow, that does sound exciting! It seems like you had a perfect job and mentor.

Answer: I have to say, though, that I also had to develop a certain amount of equanimity. Lovaas could praise me extravagantly on some occasions yet give brusque criticism at other times; tell me to insert a passage into a manuscript that he would later reproach me for, excite his whole team about a new project or idea only to abandon it at the next meeting, set an agenda but then spend an entire meeting talking about something else altogether, and appear at meetings in a jovial mood or livid because of a mistake or oversight on my part. These ups and downs could be difficult, but I came to see them as a form of creative destruction that would ultimately lead to an original, important contribution.

Q: What would you like to share with our readers that may be a little known fact about him?

Answer: Although Lovaas‘s critics often accused him of wanting to turn children with autism into drones who automatically obeyed orders, the opposite was really true. He was especially proud of the unique and unexpected achievements that his graduates went on to make–one boy who made the high school wrestling team, another who experienced new-found happiness when he came out as gay, another who started a rock band, even the girl who was caught with her friends smoking cigarettes under the school bleachers (although he and his graduate students worked with the girl‘s mother to put a stop to that one!). He spent a great deal of time reminding undergraduate and graduate students of the importance of preserving and respecting individual differences. He recognized that children in his clinic were required to comply with many demands from therapists, but he firmly believed that this requirement was the best way to help them pay attention to instruction and learn skills that they could use to develop into distinctive individuals.

Q: Can you briefly describe how you think he has most impacted the world of autism?

Answer: Lovaas showed that children with autism did not need to be confined to institutions or segregated classes and that, on the contrary they could live, learn, and thrive at home, in their neighborhood schools, and out in their communities.

Q: Given the current state of the science, has much changed since his ground-breaking study suggesting that ABA can help children lose their diagnosis? What kinds of things are different between then and now? What has stayed the same?

Answer: A generation after Lovaas‘s (1987) groundbreaking study, his intervention remains the most studied and arguably most successful comprehensive early intervention program for children with autism. However, many other things have changed. In 1987, autism was considered to be rare, affecting about 1 in 2000 children; now, however, the prevalence is estimated at about 1 in 110 children. Accordingly, intervention programs need to be implemented on a much larger scale for many more children than anyone would have anticipated in 1987. Also, we now have much clearer information than we did in 1987 on what the defining features of autism are; this information may require revising curriculum content and possibly also intervention methods. Perhaps most encouraging for the future, after many years when Lovaas and a small handful of other behavior analysts were the only ones who were systematically studying interventions for children with autism, a large and rapidly growing number of researchers with a range of backgrounds have joined the effort to test interventions for children with autism and identify ones that are effective.

Again—thank you for your time! Your experiences and insight are very interesting and you have provided some great personal insight into a giant within the autism community.

“Thoughts on Dr. Ivar Lovaas from a Parent”

Written by Harold Doherty

I never met Dr. Ivar Lovaas in person. My 14 year old son, Conor (diagnosed at age 2 with Autistic Disorder and profound Developmental Delays), was never a patient or a subject in a Lovaas study. Yet, when Dr. Lovaas passed away recently I felt that one of the most important people in my son’s life had been lost. Through his career and research he helped our family, our teachers, and autism service providers, teach my son and other children with autism. He proved to us that we could help children with autism learn to communicate, to overcome deficits, to grow, and to live more rewarding lives.

The importance of Dr. Lovaas in my son’s life stems from his research, reported in 1987 and 1993, which demonstrates that Applied Behavior Analysis (ABA) can help many children with autism overcome the cognitive, linguistic, and behavioral deficits which are often displayed in these children. Unfortunately, I cannot provide testimonial evidence that my son Conor, who is severely impaired by his disability, has recovered from autism because of ABA. This is partly because such services were not readily available in Fredericton (New Brunswick, province of Canada) where we lived at the time when Conor received his diagnosis. I did not learn about ABA until Conor was almost four years old, when the preschool development window was already closing for him. Therefore, he did not have the opportunity to receive 40 hours per week of discrete trial training between the ages of two and five. Notwithstanding the severity of my son’s condition, and his late introduction to the ABA principles that Dr. Lovaas demonstrated, he has been helped immeasurably by the effective autism intervention created through this research.

Dr. Lovaas’ work helped convince this father that ABA was the best bet on which to gamble my son’s valuable development time. That research provided me and my wife, Heather,with the confidence and the methods to help us communicate with our severely autistic son, and help him grow and develop. As parents, few gifts are greater than these. My knowledge of Lovaas and of ABA began when I attended lectures given by a clinical psychologist and University of New Brunswick (UNB) psychology professor emeritus, Paul McDonnell, PhD, who worked with children with autism and educated many parents about the Lovaas studies and about ABA principles in general.

In particular, Dr. McDonnell gave a lecture entitled, “Managing Problem Behavior in Autistic Children.” It is the only talk from the many, varied, and bewildering seminars given by various purported authorities in those early years that I can remember with any detail. It was the only presentation at which I was made aware of learning principles that would be helpful in dealing with the serious challenges a parent faces in raising a child with autism. I can still visualize a “Problem Behavior Extinction” Chart from that lecture, based on evidence, which showed how to eliminate problematic (including dangerous and self-injurious) behavior in children with autism. The effectiveness of ABA principles was not “pie-in-the-sky” nonsense. The claim of effectiveness was based on solid research, and in particular, on the research of Dr. Ivar Lovaas.

At the conclusion of that presentation by Dr. McDonnell, I immediately tried to use what I learned. That evening, in a crude application of ABA principles, I refused my son’s initial screaming for what I knew, from experience, was a favorite treat (an apple), until he started to ask for it by saying the word, “apple.” I repeated “apple” in two drawn out syllables, “Appp … pull.” Conor continued to scream. This process continued for almost 45 minutes until Conor finally said, “App.” I immediately gave him a bite of the apple. Each time he said, “App,” he got another bite. Then I insisted that he say “app-pull” to get another bite. After almost an hour and a half of this process, Conor had said “apple” several times, and without prompting.

This anecdote might not seem like much to many people, but to me it was the first time I was able to teach my son to say a word. It was the first time that I could communicate with him at all, in any meaningful way, other than by guessing what he was trying to say through his screaming. The process I just described was not easy for me to endure as a parent; to withhold what I knew my son wanted while he screamed in frustration. That experience, though, was the beginning of my ability to communicate meaningfully with my son with autism, and he with me. I was able to do it, I was able to communicate with him meaningfully, because the principles were sound and because I was convinced it would work. I was convinced it would work because of the research evidence in support of its effectiveness, especially the research by Dr. Lovaas.

Since that initial success there have been many others. Conor’s ability to communicate with us, and ours with him, has improved substantially. We used ABA principles at home and were successful at toilet training Conor well before he started school. Frustration-induced aggressive behavior toward others has been eliminated. Conor started his first year of high school, with his own curriculum and with ABA based instruction at school. Conor initially started school in a general classroom for the entire school day, but that resulted in some self-injurious hand-biting. It was resolved shortly thereafter by placement in a more quiet area for his ABA instruction, and the hand-biting disappeared. Otherwise, we have not had a single incident of aggression toward himself or others, nor problem behavior of any kind, reported to us by school officials. Conor loves attending our neighborhood schools, loves receiving his ABA based instruction, and is liked by fellow students and educational staff. I do credit Conor himself. Conor has always been naturally personable, and well liked by other children and adults, but his interaction with others has also been helped by the application of ABA principles to address his more challenging autism based behaviors.

It might surprise some to read that, here in New Brunswick, my son receives ABA based instruction in our neighborhood schools, but that has been the case for several years. The provincial government has provided ABA training to teacher assistants and resource teachers at the UNB-CEL Autism Intervention Training Program. The program is based on ABA principles and research, and has received external review by Dr. Eric Larsson of the Lovaas Institute who described it as “A remarkable and thorough program that has been developed to an exceptional level of quality in the context of limited resources. The province-wide model is one that many other provinces should adopt, as it carries with it many cost-effective features. The curriculum content requires little modification.”

The UNB-CEL program itself was based on ABA research, and includes instruction in discrete trial training. The program was first developed to train autism support workers and clinical supervisors for the preschool autism intervention treatment centers, established in New Brunswick several years ago, in response to intense parent pressure. It was adopted for use in training teacher assistants and resource teachers in our neighborhood schools, again after some determined parent advocacy. As parents supporting our children with autism, we were successful because we were focused, persistent, and well informed about autism and effective interventions. We also succeeded because we had the tools (the Lovaas studies) with which to convince political and civil service leaders that ABA was an effective evidence-based intervention that would help children with autism to learn.

Dr. Lovaas provided our family and our government with evidence that ABA is a powerful intervention for children with autism. He said that “if a child cannot learn in the way we teach, we must teach in a way the child can learn.” He also proved to us that it could be done, and showed us how to do it.

Harold Doherty is the former President of the Autism Society of New Brunswick, involved with advocacy for establishment of UNB-CEL Autism Intervention Training program, provision of ABA early intervention up to 20 hours per week provided by the Province of New Brunswick for children with autism between 2 and 5 years old. He currently advocates for autism youth and adult residential care systems in New Brunswick.

Please use the following format to cite this article:

Celiberti D., Taylor, B. (2010). A Tribute to Dr. Ivar Lovaas. Science in Autism Treatment,7(4), 8-11. Science in Autism Treatment,71(4), 8-11.