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Thursday, April 25, 2024

Early intervention with autistic children: the Lovaas Approach

By Maryse Isma, MSW

CSMS Magazine Staff Writer

Autism is a serious psychological disorder with onset in early childhood. Autistic children show minimal emotional attachment, absent or abnormal speech, retarded IQ, ritualistic behaviors, aggression, and self-injury. Although, teaching autistic children can be a major challenge, countless studies have shown that early intervention, if done intensively and properly will eventually bear tangible results.

There are many approaches to teaching young children with autism. Because of the mystery that exists behind the development of autism, many prestigious medical institutions around the world have hired a lot of experts to research the best and effective way to teach young autistic children. For instance, there is the Miller Diagnostic Survey which is an approach to teaching parents how to evaluate their autistic children’s progress or lack there of. In this approach, the parent is the expert on their child and by answering the questions on the MDS they make it possible to isolate precisely where their child most needs help so that teachers and therapists can focus their efforts where it will do the most good. All these different approaches, however, target two important symbioses: Behavior modification and cognitive development.

 Among the many different approaches, many experts agree that Lovaas approach is considered the best approach for early intervention programs.  It is based on extensive clinical experience and its focus is to serve children of all levels of functioning while providing an educational setting that allows them to achieve their individual potentials. This approach is a comprehensive one aimed at enhancing language and communication, social/play, pre-academic and independent living skills of young children so that they may take better advantage of opportunities in their communities and may require less professional attention as they grow older.

The Lovaas approach was crowned as the quintessential approach after Dr. Ivar Lovaas, distinguished professor at UCLA, published an important study on early intervention with autistic children. Lovaas died earlier this month, but his legacy will live for the foreseeable future. The study was designed to show that if intensive programs are properly delivered early in life, many of our autistic children can live a normal life. As the study demonstrates, 47% out of the 19 children who participated in the intensive, long-term experimental treatment achieved normal intellectual and educational functioning with normal IQ range scores and successful first grade performance in public schools. Forty percent of them lived with a mild retardation and were placed to Special Education classes. Only 10% of the participants were profoundly retarded and therefore were assigned to classes for autistic/retarded. When it comes to the controlled group, the difference in progress was quite substantial. Only 2 % of them achieved a normal educational functioning.       

 Early intervention may focus on the child alone or on the child and the family together. Early intervention programs may be center-based, home-based, hospital-based, or a combination. Services range from identification—that is, hospital or school screening and referral services—to diagnostic and direct intervention programs. Early intervention may begin at any time between birth and school age; however, there are many reasons for it to begin as early as possible.

 There are several reasons for intervening early with an autistic child. However, the main logic behind these reasons is to enhance the child’s development, to provide support and assistance to the family, and to maximize the child’s and family’s benefit to society.

First of all, child development research has established the rate of human learning and development is most rapid in the preschool years. Timing of intervention becomes particularly important when a child runs the risk of missing an opportunity to learn during a state of maximum readiness. If the most teachable moments or stages of greatest readiness are not taken advantage of, a child may have difficulty learning a particular skill at a later time. Karnes and Lee (1978) have noted that “only through early identification and appropriate programming can children develop their potential” (p. 1).

 Second of all, early intervention services also have a significant impact on the parents and siblings of an exceptional infant or a young child. The family of a young autistic child often feels disappointment, social isolation, added stress, frustration, and helplessness. The compounded stress of the presence of an autistic child may affect the family’s well-being and interfere with the child’s development. Families of handicapped children are found to experience increased instances of divorce and suicide, and the handicapped child is more likely to be abused than a non-handicapped child.

 Early intervention can result in parents having improved attitudes about themselves and their child, improved information and skills for teaching their child, and more release time for leisure and employment. Parents of gifted preschoolers also need early services so that they may better provide the supportive and nourishing environment needed by the child.

 Third of all, the most important reason for intervening early is that society will obtain maximum benefits. The child’s increased developmental and educational gains and decreased dependence upon social institutions, the family’s increased ability to cope with the presence of an exceptional child, and perhaps the child’s increased eligibility for employment, all provide economic as well as social benefits.

 Finally, the Lovaas approach—based on scientific research—leads us to confirm that normal children learn from their everyday environments most of their waking hours. However, autistic children, conversely, do not learn from similar environments. The research hypothesized that construction of a special, intense, and comprehensive learning environment for very young autistic children would allow some of them to catch up with their normal peers by first grade.

References

Lovaas, O. Ivar (1987). Behavioral Treatment and Normal Educational and Intellectual Functioning in Young Autistic Children. University of California, Los Angeles Press.

Lovaas, O. Ivar and Koegel, R. L. Behavior Modification with autistic Children. Chicago, Chicago University Press.

Note: Maryse Isma, MSW is a clinical social worker who lives and works in suburban Jacksonville, Florida.

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