Book Review: Teaching Individuals With Developmental Delays: Basic Intervention Techniques (Ivar Lovaas, Pro-Ed, 2003)

 

Ivar Lovaas, a professor of psychology at the University of California at Los Angeles (UCLA) and director of the Lovaas Institute for Early Intervention (LIFE), is widely regarded as the father of behavioral treatment for autism spectrum disorders.  For over 40 years, he and his colleagues have been conducting research designed to develop an optimal autism treatment protocol.

 

This book provides a theoretical overview of "Lovaas" style treatment (as it is popularly referred to), as well as a detailed description of its teaching techniques and goals.

 

Lovaas departs from a lot of the mainstream thinking about "autism" in his refusal to attach much importance to the various categorical "labels" (e.g. "autistic disorder," "PDD-NOS," "Asperger syndrome"). Likewise, he is fairly scornful of efforts to articulate some sort of comprehensive "theory" to explain autism. Over the course of his long career, Lovaas has witnessed how frequently these labels and theories get revised and how little they have contributed to the development of effective treatment approaches.

 

Lovaas finds it much more constructive to view autism spectrum disorders as involving "developmental delays."  The number and relative severity of these delays varies enormously across the autism spectrum - from the comparatively mild delays found in Asperger syndrome to the more severe problems experienced by a nonverbal child with autistic disorder.  Regardless of the specific label, these children typically exhibit behavioral excesses (e.g. self-stimulation, repetitiveness) and deficits (e.g. imitation, motivation, attention) that, if untreated, completely derail the development of normal social and learning behaviors.

 

While Lovaas' focus is on providing parents with the tools to set up an intensive (30-40 hour) home-based treatment program, his book should be of interest to anyone wanting a better understanding of how children with autism learn. Even if you are pursuing a different kind of ABA treatment program (e.g. center-based, school-based, or for an older or less impaired child), you'll probably find it very worthwhile to read Lovaas' insightful analysis of the various behavior problems commonly associated with autism spectrum disorders  (e.g.  motivation, attention, self-stimulation, tantrums) .

 

Lovaas' approach has been extremely effective for many children, especially those he describes as "auditory" learners. Like most children with autism related disorders, "auditory learners" have tremendous difficulties with language and communication. But with early and intensive behavioral treatment, they demonstrate a relatively rapid ability to acquire verbal imitation and expressive language.  These skills provide the foundation for teaching an enormous range of other behaviors necessary for developing more "normal" degrees of social relatedness and learning. With intensive treatment, a significant percentage of this subgroup can attain fully "normal" levels of functioning in every domain.

 

Only about half of the children diagnosed with autistic disorder meet this profile. Other so-called "visual" learners may benefit from a communication program developed by, Nina Lovaas (Ivar's spouse) and her colleagues called "The Reading and Writing Program" (R&W).  In a section devoted to "strategies for visual learners," there is a chapter describing the R&W program, as well as a chapter on the Picture Exchange Communication System (PECS) developed by Andy Bondy and Lori Frost.

 

The first four sections of the book are authored by Lovaas: "Basic Concepts," "Transition into Treatment," Early Learning Concepts," and "Expressive Language." Most of the chapters in the three remaining sections ("Strategies for Visual Learners,"  "Programmatic Considerations," and "Organizational and Legal Issues") are written by various collaborators, including Tristram Smith, Jacqueline Wynn, Andrew Bondy, Lori Frost, Nina Lovaas, Svein Eikeseth,  and Attorneys Gary Mayerson and Kathryn Dobel.

 

Lovaas considers this to be a "basic" manual and has plans to publish a second volume of "advanced" programs focused on more sophisticated skills. But if your child is ready for more challenging material, don't wait for that book. At least in my experience, parents who have fully absorbed the extensive theoretical and technical information presented in this book will have the foundation for devising whatever more advanced programs their child may need.

 

 

ADDITIONAL RECOMMENDATIONS

There are five indispensable books for any parent contemplating setting up a home-based intensive ABA treatment program:

1) Teaching Individuals With Developmental Delays: Basic Intervention Techniques (Ivar Lovaas, 2003)
2) Behavioral Intervention for Young Children with Autism: A Manual for Parents and Professionals (Maurice, Green,Luce, 1996)
3) Making a Difference: Behavioral Intervention for Autism (Maurice, Green, Foxx 2001);
4) A Work in Progress (Leaf and McEachin, 1999); and
5) Teach Me Language (Freeman and Dake, 1996).

 

Need to choose? I'd recommend starting with A Work in Progress and Behavioral Intervention for Young Children with Autism: A Manual for Parents and Professionals.  These manuals are less detailed and theoretical than Lovaas' book and therefore somewhat more "user-friendly."   Unless your child already has developed expressive language (as all Asperger and most older PDD-NOS kids have), Teach Me Language can wait until you see how your child progresses during the first year or so of treatment.

 

Many children, especially those whose language is progressing more slowly, can benefit immensely from the teaching techniques described in Teaching Language to Children With Autism or Other Developmental Disabilities by Mark Sundberg and James Partington.