Objects used for simple sensory feedback or self-stimulation.
Repetitive behaviors (e.g., body rocking) serve as self-stimulatory activities.
Behavioral Challenges in Autistic Children
Some children experience extreme tantrums leading to potential self-injury.
Example: Beth has extreme tantrums.
Example: John requires restraint for protection.
Inattentiveness in children like Valentin; do not seek approval from others.
Communication Deficits
Many autistic children engage in echolalia, repeating what others say.
Approximately half of all autistic children meander, showing a pattern of aimless behavior.
Behavioral Deficits and Excesses
Deficits include:
Language use.
Emotional attachment to others.
Attention to the environment.
Toy play and pure play.
Self-help skills (toileting, dressing).
Excesses include:
Self-stimulation.
Tantrums.
Aggression.
Need for Care
Over 95% of autistic children require custodial care throughout their lives.
Impact on families and society, representing a substantial loss.
Origins of Autism
Believed to be biological in origin; exact causes remain unclear.
Behavioral Treatment Approaches
Influenced by B. F. Skinner's work on operant conditioning.
Skinner's book: "The Behavior of Organisms" (1938).
Demonstrated predictable influences of consequences on behavior.
Operant conditioning defined as:
The method of reinforcing desired behavior via consequences.
A behavior followed by a reinforcer increases its likelihood of recurring in similar settings.
Reinforcers examples:
Food and drink.
Touching, hugging, or kissing.
Praise and engaging in a favorite activity.
Behavioral Case Study: Lisa
Lisa, three years old and autistic, does not speak or interact with toys.
Engaged in repetitive arranging of favorite objects.
Teacher Ivar Lovas uses operant conditioning to reinforce sitting behavior with food and praise.
Lisa exhibited tantrums when teaching was attempted; tantrums ignored to decrease frequency.
Behavioral progress recorded:
Over 18 minutes, tantrum frequency reduced significantly through reinforcement.
The extinction burst phenomenon:
Occurs when a behavior temporarily increases after reinforcement stops.
After learning to sit, Lisa begins learning other behaviors.
Historical Context and Research
In 1964, Ivar Lovas initiated a treatment program at UCLA, treating children like Pamela and Ricky.
Early treatments included simple reinforcement strategies, evolving over time.
Progress documented in speaking and social interactions:
Initially, responses were minimal; after 14 months, significant improvements noted.
Children were discharged to a state hospital where behavioral treatment resources were limited, leading to loss of skills.
Recent developments in state hospitals improved treatment efficacy.
Longitudinal Analysis of Children
Pamela's situation:
Currently lives in a state hospital; can perform basic household tasks but lost speech.
Treatment pivotal for maintaining skills and preventing regression.
Ricky:
Limited language skills and spontaneity; has some community involvement.
Both children show the impact of early treatment and the consequences of inconsistent care.
Data from 1969 highlight:
Behavioral treatments enhance appropriate behaviors and reduce issues like self-injury.
Longer treatment correlates with better outcomes despite ongoing delays in development.
Current Treatment Practices
Treatments focused on very young children (under four years old) demonstrate improved outcomes.
Treatment strategies evolved to include:
Home-based therapies integrated into children's daily lives.
Intense treatment methods extended over longer periods.
A rigorous study contrasting high-intensity treatment (40 hours/week) against lower intensity (10 hours/week).
Methodology of Treatment Groups
Characteristics of children in both treatment groups were comparable:
Age at diagnosis was similar (32 to 34 months).
IQ levels (mentally retarded range) were similar.
Predominantly boys, given the higher prevalence of autism in males.
Socioeconomic status of parents was comparable.
Common issues like lack of basic self-help skills and severe tantrums were prevalent across groups.
Outcomes of Treatment
Innovative treatment plans emphasized various developmental skills:
Looking at therapists, self-dressing, play behaviors, and speech invitation.
Intensive efforts to integrate into regular preschool settings.
Range of outcomes after treatment illustrated:
Varied improvements from limited to normal functioning.
Notable cases:
Chris displayed significant progress but lagged in language despite receiving extensive hours of instruction.
While his IQ remained consistent, self-help and adaptive skills improved significantly.
Val, Ian, and Other Systematic Improvements
Val was aggressive and non-communicative initially; significant improvements post-treatment.
Ian's initial breath of issues included severe tantrums and self-stimulation; post-treatment IQ grew considerably.
Treatment Efficacy Analysis
47% of children from the experimental group advanced to regular first-grade classes.
Comparison group showed 0% achieving this level.
Experimental group children gained an average of 20 IQ points post-treatment, contrasting with the control group's average loss of 5 points.
Children achieving normal functioning registered average gains of 37 IQ points.
Measuring Success and Future Goals
Many children indistinguishable from peers several years after treatment.
Parents express hopes for children's future educational and occupational opportunities.
The need for continuous treatment exemplified through Chris and the progression of others like Neil and Scott, who are now integrated into regular schooling.
Broader Implications of Behavior Treatment
Potential replicability of successful treatments highlights cost-effectiveness vs. institutionalization.
Continuous efforts are essential for children with slower progress rates.