User:Teromakotero/Autism/Lovaas

= Lovaas  =

Lovaas method (1981)
Six-step therapy program for autistic and severely delayed children presented by O. Ivar Lovaas to correct deficiencies in the behavior and to increase behavioral skills.

First Step: Preparing for Learning
Mutual contact and instructor’s positive control are created to the child. Practicing, i.a., sitting calmly and to have child's attention to the crucial issues in the situation. (Timonen 2009, 374-375.)

Second Step: Learning early communicative skills
Children are taught initially verbal communication. If the chances of success in verbal communication are low, then other alternative communication methods will be introduced. (Timonen 2009, 375.)

Early communicative skills are imitation of simple body movements and activities, linking objects together according to the visual elements, producing relevant sounds and words, and practicing playing (Timonen 2009, 375).

Third step: Learning self-help related basic skills
Children train skills that are related to basic activities of self-care such as eating, dressing, using the toilet, washing, tooth brushing etc. Training focuses on a few sets of skills at a time. This will ensure more effective learning. The fact that the child can follow instructions is an important starting point to learn basic skills. (Timonen 2009, 375-376.)

Fourth step: Learning communicative skills relevant to the environmental and basic activities in everyday life
Child begins practicing identification of different things and objects in accordance with instructions (taking the clothes off the hangers, identification of different parts of the body etc.). Next child practice expressive identification and expression of different things and objects (the child answers the question "What is this?", "What do you want", etc.). Then the child will practice identification of various functions and objects in accordance with instructions (getting a certain object, going to a specific person, throwing the ball on request, responding to salutation, etc.). During activities of identifying and naming a variety of pictures are used so that the child can learn to discuss the functions also symbolically. (Timonen 2009, 376-377.)

Fifth step: Learning complex communicative skills
In this step the focus is on expanding the child's ability in conceptual understanding and expressive skills. Lovaas emphasizes the importance of the development of extensive communication skills. Autistic’s and severely delayed children’s main problem is in many cases exactly in communication and interaction. Children train for example to understand and use concepts of direction and position, different sentences and phrases to express things, yes- and no-words, as well as concepts about size, shape, and color in a variety situation. (Timonen 2009, 377.)

Sixth step: The expansion of the World
In this step the focus is on the development of the child’s experiment of the world. Learned skills are practiced in various ways in natural contexts. Child participates in a variety of social functions where he/she practice to identify different emotional states, demonstration of affection and social interaction rules. (Timonen 2009, 377-378.)

Lovaas Research (1987)
The study population consisted of 19 up to 3.8-year-olds diagnosed with autism. Their intelligence age was estimated to be at least 11 months. The children of this intensive, long-term experimental treatment group received two to four years of enhanced applied behavior or behavioral therapeutic program, which was practiced around 40 hours per week at home and in the project's training facilities. (Timonen 2009, 276.)

The study included two control groups. The first 19 children control group had the same program as the experimental group, but the systematic training was less, about 10 hours per week. In another 21 children control group the children did not have behavioral therapeutic guidance, but participated in the normal follow-up of the health care system. It included general guidance and discussions with parents. (Timonen 2009, 276-277.)

There were no notable differences between the results of the two control groups, so they are discussed together in the conclusions of the study (Timonen 2009, 277).

Lovaas experimental group
The results showed that Lovaas experimental group (N = 19) 47% (9 children) reached at the age of 6 to 7 years normal intelligence level, 42% (8 children) was evaluated in mildly mentally retarded and 10% (2 children) severely mentally disabled (Timonen 2009, 277).

Control groups
In the control groups (N = 40), only 2% achieved a normal IQ level, 45% of the estimated mildly mentally retarded and 53% severely mentally handicapped (Timonen 2009, 277).