Thursday, December 07, 2006

Verbatim: A fixed glassy-eyed look

This Verbatim is in two parts, from the same paper (Koegel et al., 1974).

Here is the first part, which is Table 1 from this paper. "Subject 1" is an 8-year-old autistic boy. "Subject 2" is a 6-year-old autistic girl. Table 1 lists the behaviours the experimenters identified as self-stimulatory and requiring suppression for each child.

Table 1
Complete list of self-stimulatory responses for Subject
1 and Subject 2.

Subject 1
1. eye crossing
2. finger manipulations (moving the hands with continuous flexion and extension)
3. repetitive vocalizations (excluding recognizable words)
4. feet contortions (tight sustained flexions)
5. leg contortions (tight sustained flexions)
6. rhythmic manipulation of objects (repeatedly rubbing, rotating, or tapping objects with fingers)
7. grimacing (corners of mouth drawn out and down, revealing the upper set of teeth)
8. staring or gazing (a fixed glassy-eyed look lasting more than 3 sec)
9. hands repetitively rubbing mouth
10. hands repetitively rubbing face
11. mouthing of objects (holding nonedible objects in contact with the mouth)
12. locking hands behind head
13. hands pressing on or twisting ears

Subject 2
1. staring or gazing (a fixed glassy-eyed look lasting more than 3 sec)
2. grimacing (corners of mouth drawn out and down, revealing the upper set of teeth)
3. hand waving vertically or horizontally with fingers outstretched in front of eyes
4. hands vigorously and repetitively rubbing eyes
5. hands vigorously and repetitively rubbing nose
6. hands vigorously and repetitively rubbing mouth
7. hands vigorously and repetitively rubbing ears
8. hands vigorously and repetitively rubbing hair
9. hands vigorously and repetitively rubbing clothes
10. hands vigorously and repetitively rubbing objects
11. hand flapping in air
12. hand wringing (hands alternately rubbing and clutching each other)
13. finger contortions (tight sustained flexions)
14. tapping fingers against part of body or an object
15. tapping whole hand against part of body or object
16. mouthing of objects (holding nonedible objects in contact with the mouth)
17. rocking (moving the trunk at the hips rhythmically back and forth or from side to side)
18. head weaving (moving head from side to side in a figure-eight pattern)
19. body contortions (sustained flexions or extensions of the torso)
20. repetitive vocalizations (excluding recognizable words)
21. teeth clicking (audibly and rapidly closing teeth together)
22. tongue rolling and clicking
23. audible saliva swishing in mouth
24. repetitive tapping feet on floor
25. repetitive tapping toes inside shoes (visible through canvas tennis shoes)
26. leg contortions (tight sustained flexions)
27. repetitive knocking knees against each other
28. repetitive knocking ankles against each other
29. tensing legs and suspending feet off the ground
30. head shaking (rapid small movements from side to side)
31. tensing whole body and shaking

Here is the second part, which is from the text of this paper, and describes what the experimenters did about the behaviours listed in Table 1:

In baseline sessions, the child was allowed to engage in self-stimulation; in the suppression sessions, self-stimulatory responses were punished by one or both of the experimenters sharply saying "No!" and briskly slapping or briefly holding (immobilizing) the part of the child's body with which the response was being performed. To ensure that all self-stimulatory responses were punished on a continuous schedule, one experimenter suppressed self-stimulation from the waist up and the other from the waist down.


Reference:

Koegel, R.L., Firestone, P.B., Kramme, K.W., & Dunlap, G. (1974). Increasing spontaneous play by suppressing self-stimulation in autistic children. Journal of Applied Behavior Analysis, 7, 521-28.

25 comments:

Jackie said...

Why do these people think, that if screaming "NO!" at a child, or slapping, and grabbing them..which would be highly disturbing to a "normal" child, let alone be considered child abuse. Is somehow benificial to those with Autism?

I guess it's one of those enigmas wrapped in a mystery, wrapped in another enigma..

Anonymous said...

I hope they've changed their approach since 1974.

Michelle Dawson said...

Anonymous wrote, "I hope they've changed their approach since 1974."

The use of physical punishment as part of behaviour programs became illegal in California (where this experiment took place) in 1991.

On the other hand, the non-scientific assumption that common observable autistic behaviours must be suppressed is still in full flower in ABA-land. So is the non-scientific assumption that common observable autistic behaviours interfere with learning.

As a side dish, the behaviour analytic literature continues its long-standing tradition of classifing and describing what behaviour analysts deem to be stereotypical and/or self-stimulatory behaviours in inconsistent, subjective and contradictory ways (Dawson et al., in press, for all of the above).

Ms. Clark said...

Good grief. I might keep two ABA therapists busy, too. I recognized a bunch of those things as things I do frequently. If I'm annoying a person sitting next to me with a leg bouncing and they ask me to stop, like if I'm sitting in an auditoreum or something and I'm bouncing their seat, too... the first thing I start doing is clenching and unclenching my toes, because if I'm not doing that I'll automatically go back to bouncing my leg. I move quite a bit when I'm sitting, unless I'm sitting stone still for minutes at a time. I wonder how these kids managed to avoid being trained out of swaying when they stood. I wonder if all the agressive attempts at suppression of their stims resulted in some biting-of-the-therapist behaviors.

Anonymous said...

Clearly, this 1970's something study is way out of date. And your continued assumption that ABA is non-scientific is a total farse. I do not understand why you refuse to see this. As much reading and research as you obviously do, I am sure you know that ABA is NOT based on negative consequences for behaviors, but positive reinforcement. And I have yet to understand through reading this blog why you continue to make the claim that a child being exposed to ABA is in some way trying to cure him/her.

Michelle Dawson said...

Anonymous wrote, "Clearly, this 1970's something study is way out of date."

Clearly, this 1970s study met the highest standards of the time, something we shouldn't forget (the children who were hit in this paper are younger than me--I'm not going to forget about them either). This 1970s study was published in the flagship ABA journal. The lead author is one of the most important behaviour analysts in the world.

Re the 1970s being out of date, the children in Lovaas (1987) underwent treatment starting in 1970. Does this mean that autism advocates should stop promoting this out-of-date study--which also is dependent on aversives, as is the study I quoted from?

I've written and testified (in public, on the record, and in the media) about the extreme dependence of current-day ABA programs on massive quantities of positive extrinsic reinforcement, as well as the reported and testified consequences of this. Since you are claiming to be familiar with my work, I'll leave you to look this up.

Also, please post here all the places where I've used the word "cure" in the context of ABA-based autism interventions.

I recently wrote a blog entry about whether behaviour analysts use the word "cure", and they sometimes do. I don't have any control over the the behaviour of behaviour analysts at all, and you are again free to look up the cited sources (all public and available) to see if I'm making things up.

When there is a published, peer-reviewed controlled trial of ABA/IBI where the goal is not a child who can to the greatest extent possible pass for normal, then I'll be sure to report on it.

In the meantime, feel free to list all the ABA/IBI controlled trials in which autistic traits and abilities, including autistic learning and intelligence, are promoted rather than extinguished.

enda said...

Nothing to see here ... move along folks. 1974! FFS! As Michelle Dawson has helpfully pointed out these procedures were banned 15 years ago (though I'm amazed they weren't banned long before that). In Ireland such abuses have been banned since 1982.

Although such abuses would have been fine in 1974, so I suppose the only ethical thing to do is to refuse to deal with anyone in the teaching profession who was working before 1982. Indeed, we should probably refuse to deal with any teacher who was trained by anyone who worked before 1982.

Michelle Dawson said...

Aversives remain legal in many jurisdictions, and 15 years ago applies to California only. Abuses are never fine, any time.

I've already explained on this blog the circumstances under which there would be the last word about aversives.

If "folks" want to "move along", they'll stop citing Lovaas (1987), a study that took place largely in the 1970s and was dependent on aversives. They'll stop using lobbying tools (the Auton and Wynberg trial decisions, the NYSDOH guidelines, the US Surgeon General's report, the MADSEC report) that are overwhelmingly or entirely dependent on Lovaas (1987), that study that goes back to those far-gone 1970s and is dependent on aversives.

Funny how autism advocates cite the long history of ABA-based interventions as "proof" that they are effective, ditto with the large number (is it 700? 900? 3,000?) of published ABA-based papers, but do not want to know this history or read those papers.

enda said...

Michelle,

Executions remain legal in many jurisdictions but that does not mean we should abandon the legal system as 'unavoidably tainted' by the excesses of a few. You have valid criticisms of aversives, shared by anyone I've ever met whose sent their children to ABA schools, but by hysterically equating ABA with aversives you do your stance on ABA no favours.
Forgive me if I don't agree that acceptance of NYSDOH guidelines or American Surgeon General's Report or MADSEC equals endorsement of Lovaas. Granted, anyone who directly quotes Lovaas in support of ABA is asking for trouble. But you won that arguement years ago (at least since 1991 in California) so why keep flogging the dead horse?

Michelle Dawson said...

Hi Enda,

The fact that aversives remain legal, and are used on human beings, is a good reason to be concerned about them. I don't think clever analogies will do much for the children and adults for whom aversives are reality.

Now you can show me (1) all those autism advocates who agree with my position re aversives, as it was expressed in TMoB; and (2) all the quotes from my work where I am "hysterically equating ABA with aversives". In fact, show me one.

The NYSDOH guidelines, the Surgeon General's report, the MADSEC report, the Auton and Wynberg trial decisions all are heavily or soley (if you are concerned about peer-reviewed science) dependent on Lovaas (1987).

enda said...

Thks for you time Michelle.

2) Perhaps hysterical is overstating it, But I'm not sure how else to describe your likening of Behaviourist's alleged 'intolerance of autism' to both racism and religion. Maybe emotive and incendiary fits it better? Specifically the fact that a document, written in 2004, on ABA and Behaviourists mentions aversives more than 30 times might lead a reader to imagine that the two were inextricably linked in the mind of the author? References to 'marketing' and 'the industry' are just plain offensive.

1) It depends on what you term an autism advocate. Living on the other side of the pond as I do, I've probably never heard of most of the people you deal with in North America. I myself have never met anyone (parent or professional who thinks that beating children is the way to go). Maybe I don't move in the same circles as you do? Or perhaps your position on aversives is more nuanced than that?

Lucas said...

My own understand is that the reason why aversive get mentioned so much in discussions and articles is because those promoting ABA as an Autism treatment in Canada do as Michelle said, rely heavily on studies that relied on aversives(adversives?) to achieve the reported best-case scenario of 47% of the subjects 'recovering' and they've now realised they can't keep claiming this study has been replicated because it is un-replicable in Canada and California and would be unethical anyway if attempted elsewhere.

I've never heard anywhere else of anyone accusing an author of being fixated on something when they are in fact merely writing about those who actually are fixated on it. We'll hear a lot less about pre-1990s ABA when pre-1990s ABA stops being the main source of data by Autism-ABA advocates. Maybe then the focus can be turned to modern aversive use which is held afloat by the popular view that an Autistic person without treatment is almost certain to face doom: a self-fulfilling prophecy which only exists because it's circular and self-sustaining.

Michelle Dawson said...

Hi Enda,

Autism advocates have frequently claimed that all my writing is hysterical, emotive, incendiary, etc. They have never provided any factual foundation for this, and nor have you.

I'm sure you can pull single words out of that article and then brandish them to show that I'm a raving maniac (or whatever), but I don't see the point. The article is there for people to read (complete with notes, sources and references), and for people to verify that you have missed the point.

The problem seems to be that in some areas of science and advocacy, criticism is considered an outrage. Therefore, a person who provides criticism is outrageous (or hysterical, emotive, and incendiary).

But as I've pointed out, science that's above criticism isn't science any more, it is ideology.

Anonymous said...

Perhaps hysterical is overstating it

It's not an overstatement, it's a baseless, ad hominem attack, and "equating ABA with aversives" is equally baseless.

Enda has yet to cite a specific example of an emotional or unsupported claim. Speaking of quasi-religious faith in ABA, why would anyone find Michelle's meticulously referenced facts "incendiary" unless they challenge some entrenched belief?

Michelle, keep flogging that "dead" horse til it goes down and stays down.

enda said...

hi Michelle,
if you study my previous post, you'll notice i did refer to your likening of alleged 'intolerance of autism' to both racism and religion. If you don't regard this as incendiary then we'll have to agree to differ.

hi Xeno,
Michelle's meticulously researched facts are leavened with incendiary polemic. If Michelle and her apostles want to continue flogging the horse, far be it from me to cry 'neigh', I'm just observing that she's unlikely to persuade people by first insulting them, with references, for example, to 'industry' or 'marketing'.
You'll notice my incendiary reference to Michelle's 'apostles' does not require anyone to have an irrational faith in the correctness of her arguments to find this incendiary. Or hysterical, for that matter.

Michelle Dawson said...

Hi Enda,

Still waiting for you to provide direct quotes (those incendiary, etc, ones) from the article in question. The article in question also has a gigantic comment board attached to it, allowing anyone publicly to comment on it.

When you get around to providing direct (incendiary, etc.,) quotes, you can explain how what I wrote is not supported by the available evidence.

You can also provide all those direct quotes where I equate ABA-based autism interventions with aversives.

TMoB contains no personal insults, except for a lot of documented and referenced insults directed against autistic people. Those are the ones I oppose, as being anti-scientific and unethical.

Joseph said...

Enda:

you'll notice i did refer to your likening of alleged 'intolerance of autism' to both racism and religion

I didn't see that in this post by Michelle. I don't recall that from other posts either. But I for one do think intolerance of autism is very similar to racism. Why isn't it?

Kassiane said...

I for one consider autism equal to intolerance of race and religion.

My roommate (who was IN the early studies and has the worst PTSD EVER, may Lovaas rot in hell and be fed one. m&m. at. a. time.) and I BOTH put down "autistic" in the 'race' section of our census forms. Too far east to be standard issue caucasian, too far west-especially housemate, Im further east-to be asian...but diagnosed autistic.

And of course there's autistic culture...and religion is part of your culture.

So I have to second the question:

Why isnt it similar? we're born this way, there's a culture, et cetera.

Ball's in your court.

enda said...

Hi Michelle,
Your TMoB refers repeatedly to the "autism-ABA industry", presumably in order to denigrate the ABA professionals as huxters and charlatans and parents who chose ABA for their kids as poor deluded morons. I respectfully submit that if you are going to proceed with 'debate-by-slur', the onus is on you to back up same slurs with evidence rather than on an observer to refute them. I don't think direct quotes are necessary - we all know where to find TMoB.

As for the ABA=aversives question - perhaps I misunderstood, though if so, I suggest some of the fault lies at your door, given the many references to aversives littered throughout TMoB. Indeed, a quick perusal of this blog suggests a certain obsession with the question of aversives. That said, if I have misunderstood your position, please take this opportunity to correct my misunderstanding with a clear statement to the effect that ABA is not intrinsically dependant on aversives. I'm not holding my breath, mind you!

joseph,
Yes, you are correct. My comment refers to the contents of Michelle's "The Misbehaviour of Behaviourists" (TMoB)

Kassiane,
I'm not sure we're not veering off topic here, but I think we're discussing Michelle's likening of an alleged intolerance of autism to racism or religion. I'm not sure I disagree with you that there is such a thing as autism culture, depending, of course, on what you mean by that.

Lucas said...

I don't understand why you're calling that a slur. You seem to be making value judgements about 'industry' that others aren't.

Here in Britain we've lost a lot of industries, this is widely considered to be a BAD thing.

The majority of ABA is delivered by private practitioners is it not? It is therefore correct to refer to it in the context of an industry.

There is a vaccine industry: I think vaccines are good.

There is even a recycling industry: I think recycling in principle is good.

There can also be 'bad' industries, but the word 'industry' is certainly not an un-neutral term like you're making out. It's like saying 'liberal' or 'conservative' as if it were an insult.

Michelle Dawson said...

Hi Enda,

Adding to what Lucas wrote, in my research, the word "industry" originally came from an important FEAT official. This official clearly didn't see this word as pejorative, merely as being accurate.

My favourite report from the autism-ABA industry was in trying to ask a behaviour analyst a question based on his published research, and using the email address published as his contact information on the paper in question.

When I didn't receive a response via email after more than a month, I phoned. This phone number was the one for the large ABA-providing corporation for which this researcher is President.

I was promptly informed that any responses to queries like mine had been outsourced. It took me maybe an hour to explain to whoever answered the phone that this was maybe not an okay thing for a researcher to do.

Now you'll have to show me where I describe anyone as a "huckster" and anyone except Bruno Bettelheim as a "charlatan".

I'm not responsible for what you erroneously read into my work. That is your own problem. I've invited you many times to quote from my work statments that support anything you claim about it. I'm still waiting.

enda said...

Lucas,
I speculated as to why the term 'industry' was being used by Michelle and that it was intended pejoritavely. Maybe it's just a cultural misunderstanding, though here in Ireland you'd never hear talk of the "Nursing Industry" or the "Teaching Industry". We get English TV here too and I've never heard those terms there either. Perhaps the use of "Industry" as opposed to "Profession" or "Discipline" is intended to suggest a venal motivation on behalf of ABA "practitioners"? If however, there exists such a cultural chasm between Irish and English people on such use of terminology then perhaps it is no wonder if I misunderstand the complexities of Canadian idiom. Michelle suggests that if this is the case, then that is my problem. I suspect she is mistaken, if she is trying to do more than preach to the converted. Your analogy of conservatives and liberals is hilarious as anyone who has ever seen FOX News will attest to.

Michelle,
I clearly never said you described anyone as a charlatan or a huckster. I was merely speculating as to why you'd use the term industry in this context. As I've pointed out to Lucas, if I've misunderstood, it is more your problem than mine. The fact that you're still waiting for quotes when I've directed you many times to TMoB suggests we have descended into a Dialogue of the Deaf. I'm happy to have your readers decide who is more in need of cochlear implants.

Michelle Dawson said...

Hi Enda,

TMoB is a long article with a lot of notes, sources, etc. I can't guess which parts of it you've decided to read things into. E.g., I could not have guessed that "industry", a word I had handed to me by an important FEAT official, would be something you consider pejorative. I want to see the direct quotes you have problems with.

I'm not sure about elsewhere, but in Canada, the existence of service industries (which includes professional services) is well-recognized.

Lucas said...

Nursing and teaching do not have industries as they are traditionally vocations, though they have in recent years shifted towards being simply 'jobs'.

Culturally they are also traditional charitable professions.

Had ABA first been a service provided by religious organisations as teaching and nursing were(was never going to be likely though), it would have begun as a vocation.

Behaviourism is a science and most science spawn some kind of industry. Nursing and teaching are not devoid of science, but were not originally sciences. I don't think this was a cultural misunderstanding, I just think the history was ignored. I'm hoping you'll start being a bit more civil and stop resorting to double-speak whilst accusing others of it.

In case you didn't notice:

"presumably in order to denigrate the ABA professionals as huxters and charlatans and parents who chose ABA for their kids as poor deluded morons. "

"I clearly never said you described anyone as a charlatan or a huckster. I was merely speculating as to why you'd use the term industry in this context."

These two statements are mutually exclusive, they can't both be correct. When you say 'presumably', you have admitted to presuming, you're way past speculation which in itself is downright rude before you've sought clarification which is easy to come by.

If you're going to blame others when you insert meanings that aren't there into what they write, please explain how it is their fault.

Anne said...

While I very much enjoy the word "incendiary" and plan to use it at the next available opportunity, I don't think the use of the phrase "autism-ABA industry" rises to that level. We don't have a "nursing industry," but nurses would be part of our health care industry. And while we may not have a "teaching industry," we do have an education industry.

If you consider the word "marketing" offensive, then you might be surprised to find that mainstream autism organizations do not. Autism Speaks, for example, has Bill Shea, a former advertising exec, working on advertising and the development of "branded marketing materials." And, of course, that same organization has teamed up with companies in a variety of industries as part of its marketing campaign -- including the entertainment industry, the stock car racing industry, and the breakfast food industry. I don't really know why you are singling out Michelle for using the words "industry" and "marketing." Makes no sense to me.

I suppose one could consider it incendiary to liken "intolerance to autism" to racial or religious intolerance if one thought that intolerance to autism was a good thing.