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Ole Ivar Lovaas

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Ole Ivar Løvaas (8 May 1927 – 2 August 2010)[1][2] was a Norwegian-American clinical psychologist and professor at the University of California, Los Angeles. He is most well known for his research on what is now called applied behavior analysis (ABA) to teach autistic children through prompts, modeling, and positive reinforcement. His application of the science was also noted for its use of aversives (punishment) to reduce undesired behavior, which are no longer supported as a part of most ABA treatment plans.

O. Ivar Løvaas
Born
Ole Ivar Løvaas

8 May 1927
Lier, Norway
Died2 August 2010 (aged 83)
Lancaster, California, US
NationalityNorwegian American
EducationUniversity of Washington, PhD
Occupation(s)Clinical psychologist, researcher
Employer(s)Professor emeritus, University of California, Los Angeles
Known forApplied behavior analysis
Discrete trial training
Autism
Spouse(s)
Nina Watthen
​
(m. 1986)​

Beryl Scoles (m. 1955; divorced)
Websitehttp://www.lovaas.com/

Løvaas founded the Lovaas Institute and co-founded the Autism Society of America. He is also considered a pioneer of ABA due to his development of discrete trial training and early intensive behavioral intervention for autistic children.

His work influenced how autism is treated, and Løvaas received widespread acclaim and several awards during his lifetime,[3] but also strong criticisms from many autistic self advocates and researchers supporting the autism rights movement and neurodiversity paradigm.[4] [5]

Personal life

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Løvaas was born in Lier, Norway on 8 May 1927 to Hildur and Ernst Albert Løvaas.[1] He had two siblings: an older sister named Nora and a younger brother named Hans Erik.[6] Løvaas attended Hegg Elementary School in Lier from 1934 to 1941. He attended junior high school at Drammen Realskole until 1944, and then moved on to Drammen Latin School for high school, graduating in 1947.[6]

Following World War II, Løvaas moved to the United States. There he married Beryl Scoles in 1955, and together they had four children. Løvaas later divorced his wife and remarried Nina Watthen in 1986.[2][7]

Career

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After graduating from high school, Løvaas served in the Norwegian Air Force for 18 months. He was a forced farm worker during the 1940s Nazi occupation of Norway, and often said that observing the Nazis had sparked his interest in human behavior.[7]

He attended Luther College in Decorah, Iowa, graduating in 1951 after just one year with his B.A. in sociology. Løvaas received his Masters of Science in clinical psychology from the University of Washington in 1955, and his PhD in learning and clinical psychology from the same school 3 years later.[6]

Early in his career, Løvaas worked at the Pinel foundation, which focused on Freudian psychoanalysis.[6] After earning his PhD, he took a position at the University of Washington's Child Development Institute, where he first learned of behavior analysis. Løvaas began teaching at UCLA in 1961 in the Department of Psychology, where he performed research on children with autism spectrum disorder at the school's Neuropsychiatric Institute.[8] He started an early intervention clinic at UCLA called the UCLA Young Autism Project, which provided intensive intervention inside the children's homes. He was named professor emeritus in 1994. Løvaas also established the Lovaas Institute for Early Intervention (LIFE) that provides interventions based on his research.[6][9]

Løvaas taught now prominent behaviorists, such as Robert Koegel, Laura Schreibman, Tristram Smith, Doreen Granpeesheh, John McEachin, Ron Leaf, Jacquie Wynn, and thousands of UCLA students who took his "Behavior Modification" course during his 50 years of teaching. He also co-founded what is today the Autism Society of America (ASA), published hundreds of research articles and several books, and received many accolades for his research. Due to this research, a number of school districts have adopted his programs. His work influenced how autism is treated.[9][10][11][12]

Research

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Autism intervention

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Early research

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Løvaas prompting several young research subjects and using food as a reinforcer, ca. 1965

Løvaas established the Young Autism Project clinic at UCLA in 1962, where he began his research, authored training manuals, and recorded tapes of him and his graduate students implementing errorless learning—based on operant conditioning and what was then referred to as behavior modification—to instruct autistic children. He later coined the term "discrete trial training" to describe the procedure, which was used to teach listener responding, eye contact, fine and gross motor imitation, receptive and expressive language, academic, and a variety of other skills. In an errorless discrete trial, the child sits at a table across from the therapist who provides an instruction (i.e., "do this", "look at me", "point to", etc.), followed by a prompt, then the child's response, and a stimulus reinforcer. The prompts are later discontinued once the child demonstrates proficiency. During this time, Løvaas and colleagues also employed physical aversives (punishment), such as electric shocks and slaps, to decrease aggressive and self-injurious behavior, as well as verbal reprimands if the child answered incorrectly or engaged in self-stimulatory behavior.[1][11][13]

1987 study

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In 1987, Løvaas published a study[14] which demonstrated that, following forty hours a week of treatment, 9 of the 19 autistic children developed typical spoken language, increased IQs by 30 points on average, and were placed in regular classrooms. A 1993 follow-up study[15] found that 8 maintained their gains and were "indistinguishable from their typically developing peers", scoring in the normal range of social and emotional functioning. His studies were limited because Løvaas did not randomize the participants or treatment groups. This produced a quasi-experiment in which he was able to control the assignment of children to treatment groups. His manipulation of the study in this way may have been responsible for the observed effects. The true efficacy of his method cannot be determined since his studies cannot be repeated for ethical reasons.[16][17][18] A 1998 study subsequently recommended that EIBI programs be regarded with skepticism.[18] In 1999, the United States Surgeon General's office wrote, "Thirty years of research has demonstrated the efficacy of applied behavioral methods in reducing inappropriate behavior and in increasing communication, learning, and appropriate social behavior", and he also endorsed the 1987 study.[19]

Literature reviews

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According to a 2007 review study in Pediatrics, "The effectiveness of [EIBI] in [autism spectrum disorder] has been well-documented through 5 decades of research by using single-subject methodology and in controlled studies... in university and community settings." It further stated, "Children who receive early intensive behavioral treatment have been shown to make substantial, sustained gains in IQ, language, academic performance, and adaptive behavior as well as some measures of social behavior, and their outcomes have been significantly better than those of children in control groups." However, the study also recommended to later generalize the child's skills with more naturalistic ABA-based procedures, such as incidental teaching and pivotal response treatment, so their progress is maintained.[20]

Another review in 2008 described DTT as a "'well-established' psychosocial intervention for improving the intellectual performance of young children with autism spectrum disorders..."[21] In 2011, it was found that the intervention is effective for some, but "the literature is limited by methodological concerns" due to there being small sample sizes and very few studies that used random assignment,[22] and a 2018 Cochrane review subsequently indicated low-quality evidence to support this method.[8] Nonetheless, a meta-analysis in the same journal database concludes how some recent research is beginning to suggest that because of the heterology of ASD, there are a wide range of different learning styles and that it is the children with lower receptive language skills who acquire spoken language from Løvaas' treatment.[23] In 2023, a multi-site randomized control trial study of 164 participants indicated similar findings.[24]

UCLA Feminine Boy Project

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See also: Conversion therapy

Løvaas co-authored a study with George Rekers in 1974 where they attempted to modify the behavior of feminine male children through the use of rewards and punishment with the goal of preventing them from becoming adult transsexuals.[25][26][27][28] The subject of the first of these studies, a young boy at the age of 4 at the inception of the experiment, died by suicide as an adult in 2003; his family attribute the suicide to this treatment. Despite the follow-up study (which Løvaas was not involved in) writing that the therapy successfully converted his homosexuality, his sister expressed concerns that it was overly biased as "he was conditioned to say that", and she read his journal, which described how he feared disclosing his sexual orientation due to his father spanking him as a child as punishment for engaging in feminine behavior, such as playing with dolls.[25][29][30][31]

In October 2020, the Journal of Applied Behavior Analysis officially issued an Expression of Concern about the Rekers and Løvaas study.[32] In the editorial accompanying the Expression of Concern, the journal discusses the damage done by the study. It emphasizes that the study inflicted personal harm upon the study's subject and his family, as well as to the gay community, for inappropriately promoting the study as evidence that conversion therapy is effective. It also argues that the field of behavior analysis was harmed by the false portrayal that the study and the use of conversion therapy are currently representative of the field.[32]

Awards and accolades

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Løvaas received praise from several organizations during his lifetime. In 2001, he was given the Society of Clinical Child and Adolescent Psychology Distinguished Career Award.[3] He received the Edgar Doll Award from the 33rd Division of the American Psychological Association, the Lifetime Research Achievement Award from the 55th Division of the American Psychological Association, and the Award for Effective Presentation of Behavior Analysis in the Mass Media by the Association for Behavior Analysis International. Løvaas also earned a Guggenheim fellowship and the California Senate Award, which is an honorary doctorate. He was named a Fellow by Division 7 of the American Psychological Association and was given the Champion of Mental Health Award by Psychology Today.[33]

Criticism

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The goal of making autistic people indistinguishable from their peers has attracted significant backlash from autistic advocates. Julia Bascom of the Autistic Self Advocacy Network (ASAN) has said "ASAN's objection is fundamentally an ethical one. The stated end goal of ABA is an autistic child who is 'indistinguishable from their peers'—an autistic child who can pass as neurotypical. We don’t think that’s an acceptable goal. The end goal of all services, supports, interventions, and therapies an autistic child receives should be to support them in growing up into an autistic adult who is happy, healthy, and living a self-determined life."[34][when?]

Løvaas has also been criticized for his view of autistic people in relation to other people, as he said in a statement during an interview, "You start pretty much from scratch when you work with an autistic person. You have a person in the physical sense - they have hair, a nose, a mouth - but they are not people in the psychological sense."[35][36]

Aversives

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Løvaas is credited with popularizing the use of aversives in behavior modification, as shown in a Life magazine photo spread in 1965.[37]

He later admitted that they were only temporarily effective and punishments became less effective over time.[38] Eventually, Løvaas abandoned these tactics, telling CBS in a 1994 interview, "These people are so used to pain that they can adapt to almost any kind of aversive you give them."[39]

See also

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Human rights

Behaviorism

Bibliography

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  • The Autistic Child: Language Development Through Behavior Modification, 1977
  • Teaching Developmentally Disabled Children: The Me Book, 1981
  • Teaching Individuals With Developmental Delays: Basic Intervention Techniques, 2003

References

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  1. ^ a b c Larsson, Eric V; Wright, Scott (2011). "O. Ivar Lovaas (1927–2010)". The Behavior Analyst. 34 (1): 111–114. doi:10.1007/BF03392239. PMC 3089401.
  2. ^ a b Fox, Margalit (August 2010). "O. Ivar Lovaas, pioneer in developing therapies for autism, dies at 83". The New York Times. Retrieved 18 June 2018.
  3. ^ a b SCCAP Award Winners: Division 53, (Retrieved 29 May 2018)
  4. ^ Ne'Eman, A. (2021). "When Disability is Defined by Behavior, Outcome Measures Should Not Promote "Passing"". AMA Journal of Ethics. 23 (7): E569–E575. doi:10.1001/amajethics.2021.569. PMC 8957386. PMID 34351268.
  5. ^ "Applied Behavior Analysis (ABA)".
  6. ^ a b c d e Eikeseth, Özerk, Özerk, Vea. Ole Ivar Lovaas – His life, merits, and legacy., International Journal of Elementary Education, Dec. 2016
  7. ^ a b "Ole Ivar Lovaas dies at 83; UCLA psychology professor pioneered autism treatment". Los Angeles Times. 6 August 2010. Retrieved 7 October 2019.
  8. ^ a b Reichow B, Hume K, Barton EE, Boyd BA (May 2018). "Early intensive behavioral intervention (EIBI) for young children with autism spectrum disorders (ASD)". The Cochrane Database of Systematic Reviews. 5 (10): CD009260. doi:10.1002/14651858.CD009260.pub3. PMC 6494600. PMID 29742275.
  9. ^ a b Smith, Tristram; Eikeseth, Svein (March 2011). "O. Ivar lovaas: pioneer of applied behavior analysis and intervention for children with autism". Journal of Autism and Developmental Disorders. 41 (3): 375–378. doi:10.1007/s10803-010-1162-0. ISSN 1573-3432. PMID 21153872. S2CID 207159059.
  10. ^ Larsson EV, Wright S (2011). "O. Ivar Lovaas (1927–2010)". The Behavior Analyst. 34 (1): 111–114. doi:10.1007/BF03392239. PMC 3089401.
  11. ^ a b Smith, T.; Eikeseth, S. (2011). "O. Ivar Lovaas: Pioneer of applied behavior analysis and intervention for children with autism". J Autism Dev Disord. 41 (3): 375–378. doi:10.1007/s10803-010-1162-0. PMID 21153872. S2CID 207159059.
  12. ^ Leaf, Ronald; McEachin, John; Taubman, Mitchell (2008). Sense and nonsense in the behavioral treatment of autism: It has to be said. New York: DRL. pp. 13–35. ISBN 978-0-975-58599-3.
  13. ^ Bowman RA, Baker JP (March 2014). "Screams, slaps, and love: The strange birth of applied behavior analysis". Pediatrics. 133 (3): 364–366. doi:10.1542/peds.2013-2583. PMID 24534411. S2CID 28137037.
  14. ^ Lovaas, O. Ivar (1987). "Behavioral treatment and normal educational and intellectual functioning in young autistic children". Journal of Consulting and Clinical Psychology. 55 (1): 3–9. doi:10.1037/0022-006x.55.1.3. ISSN 1939-2117. PMID 3571656.
  15. ^ Lovaas, O. Ivar; Smith, Tristram (1988), "Intensive Behavioral Treatment for Young Autistic Children", Advances in Clinical Child Psychology, Boston, MA: Springer US, pp. 285–324, doi:10.1007/978-1-4613-9829-5_8, ISBN 978-1-4613-9831-8, retrieved 18 November 2020
  16. ^ Boyd, R. D. (June 1998). "Sex as a possible source of group inequivalence in Lovaas (1987)". Journal of Autism and Developmental Disorders. 28 (3): 211–215. doi:10.1023/a:1026065321080. ISSN 0162-3257. PMID 9656132. S2CID 40178588.
  17. ^ Schopler, E.; Short, A.; Mesibov, G. (February 1989). "Relation of behavioral treatment to "normal functioning": comment on Lovaas". Journal of Consulting and Clinical Psychology. 57 (1): 162–164. doi:10.1037/0022-006x.57.1.162. ISSN 0022-006X. PMID 2925968.
  18. ^ a b Gresham, F. M.; MacMillan, D. L. (February 1998). "Early intervention project: Can its claims be substantiated and its effects replicated?". Journal of Autism and Developmental Disorders. 28 (1): 5–13. doi:10.1023/a:1026002717402. ISSN 0162-3257. PMID 9546297. S2CID 7219819.
  19. ^ Center for Homeland Defense and Security (1999). "Mental health: A report of the surgeon general". National Institute of Environmental Health Sciences, Substance Abuse and Mental Health Services Administration, Department of Health and Human Services: 164. Retrieved 28 August 2020.
  20. ^ Myers SM, Johnson CP (November 2007). "Management of children with autism spectrum disorders". Pediatrics. 120 (5): 1162–1182. doi:10.1542/peds.2007-2362. PMID 17967921.
  21. ^ Rogers SJ, Vismara LA (January 2008). "Evidence-based comprehensive treatments for early autism". Journal of Clinical Child and Adolescent Psychology. 37 (1): 8–38. doi:10.1080/15374410701817808. PMC 2943764. PMID 18444052.
  22. ^ Warren Z, McPheeters ML, Sathe N, Foss-Feig JH, Glasser A, Veenstra-VanderWeele J (May 2011). "A systematic review of early intensive intervention for autism spectrum disorders". Pediatrics. 127 (5): 1303–1311. doi:10.1542/peds.2011-0426. PMID 21464190. S2CID 10553507.
  23. ^ Brignell A, Chenausky KV, Song H, Zhu J, Suo C, Morgan AT (November 2018). "Communication interventions for autism spectrum disorder in minimally verbal children". Cochrane Database of Systematic Reviews. 2018 (11): CD01234PMC. doi:10.1002/14651858.CD012324.pub2. PMC 6516977. PMID 30395694.{{cite journal}}: CS1 maint: multiple names: authors list (link)
  24. ^ Kasari C, Shire S, Shih W, Landa R, Levato L, Smith T (June 2023). "Spoken language outcomes in limited language preschoolers with autism and global developmental delay: RCT of early intervention approaches". Autism Research. 16 (6): 1236–1246. doi:10.1002/aur.2932. PMC 10460274. PMID 37070270.{{cite journal}}: CS1 maint: multiple names: authors list (link)
  25. ^ a b Rekers, George A.; Lovaas, O. Ivar (1974). "Behavioral treatment of deviant sex-role behaviors in a male child". Journal of Applied Behavior Analysis. 7 (2): 173–190. doi:10.1901/jaba.1974.7-173. PMC 1311956. PMID 4436165. (This paper currently has an expression of concern, see doi:10.1002/jaba.781, PMID 33084123,  Retraction Watch. If this is an intentional citation to a such a paper, please replace {{expression of concern|...}} with {{expression of concern|...|intentional=yes}}.)
  26. ^ Rekers, George A.; Lovaas, O. Ivar; Low, Benson (June 1974). "The behavioral treatment of a "transsexual" preadolescent boy". Journal of Abnormal Child Psychology. 2 (2): 99–116. doi:10.1007/BF00919093. PMID 4430820. S2CID 23599014.
  27. ^ Rekers, George A.; Bentler, Peter M.; Rosen, Alexander C.; Lovaas, O. Ivar (Spring 1977). "Child gender disturbances: A clinical rationale for intervention". Psychotherapy: Theory, Research & Practice. 14 (1): 2–11. doi:10.1037/h0087487.
  28. ^ Rekers, George A.; Rosen, Alexander C.; Lovaas, O. Ivar; Bentler, Peter M. (February 1978). "Sex-role stereotypy and professional intervention for childhood gender disturbance". Professional Psychology. 9 (1): 127–136. doi:10.1037/0735-7028.9.1.127.
  29. ^ Bronstein, Scott; Joseph, Jessi (7 June 2011). "Therapy to change 'feminine' boy created a troubled man, family says". CNN. Retrieved 9 June 2011.
  30. ^ Szalavitz, Maia (8 June 2011). "The 'sissy boy' experiment: Why gender-related cases call for scientists' humility". Time. Retrieved 9 June 2011.
  31. ^ Warren Throckmorton (9 June 2011). "Experts and homosexuality: Don't try this at home". HuffPost. Retrieved 9 June 2011.
  32. ^ a b "Expression of Concern". Journal of Applied Behavior Analysis. 53 (4): 1837. September 2020. doi:10.1002/jaba.781. PMID 33084123.
  33. ^ IshYoBoy.com. "Dr. Ole Ivar Lovaas | Pioneer of Applied Behavior Analysis (ABA)". The Lovaas Center. Retrieved 18 June 2018.
  34. ^ "Applied behavior analysis (ABA)". Therapist Neurodiversity Collective. Archived from the original on 29 November 2021. Retrieved 20 August 2020.
  35. ^ Chance, Paul (January 1974). "'After you hit a child, you can't just get up and leave him; you are hooked to that kid': A conversation with Ivar Lovaas about self-mutilating children and how their parents make it worse". Psychology Today. New York, NY: Sussex Publishers. p. 76. You see, you start pretty much from scratch when you work with an autistic child. You have a person in the physical sense—they have hair, a nose, and a mouth—but they are not people in the psychological sense.
  36. ^ Fletcher-Watson, Sue; Happé, Francesca (2019). Autism: A New Introduction to Psychological Theory and Current Debates (2nd ed.). New York, NY: Routledge. p. 25. ISBN 978-1138106123.
  37. ^ "Screams, Slaps, and Love: A Surprising, Shocking Treatment Helps Far-Gone Mental Cripples". Life. 7 May 1965. Retrieved 24 October 2020.
  38. ^ Gonnerman, Jennifer. "The school of shock". Mother Jones. Retrieved 16 August 2020.
  39. ^ "Eye to Eye". TV Guide. Retrieved 18 November 2020.

Further reading

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