Obituary: Psychologist who first said autism is treatable dies

From The NY Times:

O. Ivar Lovaas (pictured), a psychologist who developed one of the most widely used therapies for children with autism, and in doing so helped change the treatment and the public perception of the condition, died on Aug. 2 in Lancaster, Calif. He was 83.

A longtime resident of Malibu, Calif., Dr. Lovaas (pronounced LOW-vahss) died from complications of recent surgery, his son, Erik, said. He had also been ill with Alzheimer’s disease. At his death, Dr. Lovaas was an emeritus professor of psychology at the University of California, Los Angeles, where he had taught since 1961.

Dr. Lovaas was the first researcher to suggest that for at least some children, autism is treatable. His work came to wide attention in 1987, when he published a scholarly article titled “Behavioral Treatment and Normal Educational and Intellectual Functioning in Young Autistic Children.”

In it, Dr. Lovaas reported that after rigorous training, some autistic children had been able to catch up to their peers and function in conventional classrooms.

“His work first of all showed that the kids were teachable,” Tristram Smith, a psychologist at the University of Rochester, said Friday. “It was also very important in deinstitutionalization, showing that you could teach the kinds of skills that the kids needed to succeed at home and in the community.”

In the 1960s, when Dr. Lovaas began studying autism, the prevailing Freudian view rooted the condition in neurosis. Autistic children, if they were treated at all, were given psychotherapy, to little discernible effect. Others, including many of Dr. Lovaas’s early research subjects, were misdiagnosed as schizophrenic or mentally retarded and consigned to institutions.

Dr. Lovaas, by contrast, took a behaviorist approach, proposing that autism might be ameliorated through a rigorous one-on-one program of behavior modification. The program he devised, known familiarly as the Lovaas model, took as its starting point a discipline known as applied behavior analysis.

Drawing on the work of behavioral psychologists like Ivan Pavlov and B. F. Skinner, applied behavior analysis, or A.B.A., uses behavior-modification techniques to treat social and psychological problems like drug abuse and mental illness.

The Lovaas model emphasized intensive repetition: the autistic child worked 35 to 40 hours a week with a teacher or parent trained in the method. It also stressed early intervention, with children ideally starting therapy before the age of 3 ½.

At the heart of the model was a system of rewards and punishments intended to reinforce appropriate behaviors and discourage inappropriate ones. Social skills were broken down into discrete, learnable units. (Hand-washing, for example, would be taught as a series of steps — turning on the faucet, using the soap, drying the hands — to be mastered individually.)

Thus, with training, the autistic child might progress from learning a simple task like sitting quietly in a chair to more difficult ones like making eye contact and, ultimately, speaking freely and intelligibly.

Early on, Dr. Lovaas’s method was criticized as being overly punitive. In 1965, Life magazine reported on the work he and his associates were doing with autistic children at U.C.L.A. To deter unwanted behaviors like shrieking, head banging and self-mutilation, the article reported, researchers might slap the children or, in rare cases, administer electric shocks.

Over time these practices were eliminated. Today, the Lovaas model uses only positive reinforcements, like food, affection and tickling, to reward appropriate behaviors.

Dr. Lovaas’s 1987 article, published in The Journal of Consulting and Clinical Psychology, reported the results of a study of autistic 2- and 3-year-olds he began in 1970. At the outset, most of the children functioned at a low level and spoke little, if at all.

Nineteen received 40 hours a week of intensive behavior modification for several years. By the time they were 7, nine members of this group showed a gain of 30 I.Q. points and could function in regular first-grade classrooms. Children in the control group, who got only 10 hours of weekly therapy, showed little intellectual or social change.

In a follow-up report, published in 1993, Dr. Lovaas re-examined the nine successful children when they were 13. Eight were still able to function in regular classes and had maintained the gain in I.Q.

Though Lovaas therapy can cost tens of thousands of dollars a year, parents of autistic children clamored for it. In 1995, Dr. Lovaas founded the Lovaas Institute, based in Los Angeles, which trains teachers in his method. Today, thousands of children throughout the United States and abroad are receiving Lovaas therapy.

Ole Ivar Lovaas was born on May 8, 1927, in Lier, Norway, near Oslo. His father was a journalist, but during the Nazi occupation of Norway the family, Ole included, were forced to become agricultural laborers, working in the fields for 10 hours a day. A violinist, Ole attended Luther College in Decorah, Iowa, on a music scholarship, graduating in 1951. He earned a Ph.D. in psychology from the University of Washington in 1958.

Dr. Lovaas’s first marriage, to Beryl Scoles, ended in divorce. He is survived by his wife, Nina Lovaas; four children from his first marriage, a son, Erik — who founded the Lovaas Center, a separate organization based in Las Vegas that carries out his father’s work — and three daughters, Kari Cole, Lisa Lovaas and Randi McAfee; six grandchildren; and three great-grandchildren.

Even now, no one is certain why the Lovaas model works for some children and not others. Nor have researchers been able to replicate the precise level of success Dr. Lovaas reported in his 1987 study. Dr. Smith, who did his graduate work under Dr. Lovaas, published the results of his own similar study in 2000.

“We had about a quarter of the kids enter regular education, and we had I.Q. gains of about 16 points relative to the group of kids that didn’t get intensive treatment,” Dr. Smith said on Friday. “That’s pretty good, but it’s not 50 percent, and it’s not 30 I.Q. points.”

A plain-spoken man, Dr. Lovaas took pains in interviews to say that when it came to treating autism, there was no magic bullet.

“A cure would mean we removed the neurological deviation,” he told The Wisconsin State Journal in 1994. “We don’t do that. What we do is help them obtain a normal life.”

To the end of his career, Dr. Lovaas was adamant that applied behavior analysis was supremely useful in childhood interventions of all kinds.

“If I had gotten Hitler here at U.C.L.A. at the age of 4 or 5,” he told Los Angeles magazine in 2004, “I could have raised him to be a nice person.”