It is a term which refers to applying, for therapeutic purposes, information gained from the careful examination (analysis) of what a person says or does (behavior) in a given situation or set of circumstances. Learning Theory has demonstrated that how a person behaves is largely determined by various factors (called antecedents) involved in the situation in which he or she is, and the results (called “consequences”) of his or her behavior on previous occasions. By knowing and understanding what these antecedents and consequences are, strategies can be put in place to change them, and thus change the person’s behavior.
It is a strategy or technique derived from Applied Behavior Analysis. It is a powerful method for teaching any number of skills- from Language to Maths, to Social Skills. It is a very structured method, and usually involves teaching in a one-to-one situation. Tasks to be learned are presented to the learner in a series of separate (discrete), brief sessions (“trials”) during which he or she is expected to focus solely on the task. Successful attempts are rewarded; unsuccessful attempts are corrected through prompting. The child must experience the situation as positive and pleasing for learning to be effective. It is a fallacy to think that DTT is always at a table top – it is best achieved in a natural situation with the structure provided.
The Lovaas Approach is really just another name for the use of the techniques of Applied Behavior Analysis and Discrete Trial Training in developing skills in children with Autism. It is named after O. Ivar Lovaas (see below) who first demonstrated the efficacy of this approach.
O. Ivar Lovaas was a professor of Psychology at the University of California at Los Angeles (UCLA). His early work involved teaching language to non-verbal, autistic children. He did this using principles derived from Learning Theory, using what is now commonly called Applied Behavior Analysis. He later used a similar but more refined approach to teaching a range of functional (academic and social) skills to preschoolers with Autism. Almost half of the children who were treated achieved normal levels of functioning and the rest showed significant improvement. This was the first time that any significant improvement was documented on children with Autism. The late Prof. Lovaas, who was originally from Norway, established the Lovaas Institute for early intervention in Autism in Los Angeles, which carries on his work.
It cannot be said that ABA/DTT therapy “cures” autism. The term some use is “recovery”. The evidence indicates that after 30-40 hours of intervention per week some children (40-50%) can become indistinguishable from other typically developing children and lose the symptoms of autism, while all others will make gains that could not be otherwise expected – they will make considerable improvements.
The answer to this will be different for every child. In general, however, the answer is “the more hours the better”, and the earlier in the child’s life that it starts, the better. Our experience and evidence to date suggest that in order to maximize the gains a child can make, a minimum of thirty hours a week, over a two year period is necessary. However significant gains have been made on less, particularly if parents also add hours.
Yes, but the improvements in functioning are not usually as dramatic as is often seen in children with autism.
Yes, and the changes have been for the better!
A therapy technique where the therapist works on challenging and correcting inappropriate cognitions (“thoughts”), which lead to behaviors that may need changing. Usually homework to achieve behavior change, derived from an analysis of why a person may be behaving in a certain way, is given. This approach suits the older and higher functioning child with ASD as it provides a concrete explanation for thought processes, and practical experiences to achieve behavior change.
No. Only poorly planned and/or badly administered intervention would lead to a child appearing “robotic”. The technical term for what people call “robotic” behavior is “prompt bound”. The aim of good ABA is to reduce prompt dependency and produce generalization. This aim needs to be part of the program, but it can be forgotten by unqualified practitioners. People with ASD tend to fall into routines and rituals if left to their own devices, and it is the task of an ABA practitioner to program for this to be avoided.
No! While in some cases, early therapy sessions may seem harsh, as the therapist must break through the child’s negative behaviors, children quickly learn that their therapy sessions can be fun, and begin to look forward to them.
Inappropriate behaviors must be managed if the child is to progress, but aversive consequences and punishments are not used. An ABA program is based on reinforcement and it is up to the practitioner to find what is most reinforcing for the child, as without motivation learning will not take place. If children are not enjoying therapy within a few weeks then something is wrong and needs to be looked into.
No again! It is a fallacy to call therapy work. Children with ASD are glad to be involved in hours of engagement and entertainment with an adult who provides undivided attention to them. As these children otherwise cannot and do not play, their day is very boring and they fill their time with repetitive and meaningless behaviors or sensation seeking.