Saturday, November 04, 2006

Do behaviour analysts say "cure"?

According to the Auton trial decision, one of the major ways critics of ABA-based interventions have screwed up is by using the word "cure":

First, it is said, incorrectly, that Lovaas and his followers purport to claim that Lovaas Autism Treatment “cures” autism. In fact, neither Lovaas nor those who support him have ever claimed that Lovaas therapy “cures” autism.

So is Madame Justice Allen, the trial judge in Auton, correct?

From her own decision, 36 paragraphs after the statement above, here is Justice Allen again:

Providing a number of supportive services to a disorder that with treatment we know that half could recover, is tantamount to withholding treatment and continuing with support and respite services for AIDS patients after a treatment that can cure half of them has been discovered.

In fact, this is Justice Allen quoting directly from the British Columbia behaviour analyst Glen Davies. Dr Davies (who is not an MD) was an expert witness for the ABA parents in Auton, and is undoubtedly an enthusiastic supporter of Ivar Lovaas. This reads like a claim of cure to me, with the added kick of equating autism with a fatal disease.

How about Dr Lovaas himself? From Lovaas and Smith (1989):

Intensive behavioral interventions may act to reverse whatever neurological difficulties are involved in autistic children's problems. If so, they may come close to providing a "cure" for the problems.

This is a speculative and qualified statement, and it reflects the behaviour analytic view of autism as a series of behavioural "problems". But if Drs Lovaas and Smith had not intended to claim to some degree that ABA-based intensive interventions may "cure" autism, they would have used a different word.

In a similar context, Dr Lovaas also used the word "cure" in 1974, in making speculative claims about an apparently successful early ABA-based intensive intervention. From Rekers, Lovaas, and Low (1974):

Only followup data will allow us to claim a cure for (or prevention of) the severe adult sexual pathologies of transvestism and transsexualism or some forms of homosexuality.

So while Dr Lovaas and his "followers" don't routinely claim that ABA-based interventions can "cure" autism or other conditions they have equally assumed to be "severe" pathologies, it's inaccurate to state that no claims of "cure" have been made at all.


Auton et al. v. AGBC, 2000 BCSC 1142 (CanLII)

Lovaas, O.I., and Smith, T. (1989). A comprehensive behavior theory of autistic children: Paradigm for research and treatment. Journal of Behavior Therapy and Experimental Psychiatry, 20, 17-29.

Rekers, G.A., Lovaas, O.I., and Low, B. (1974). The behavioral treatment of a "transsexual" preadolescent boy. Journal of Abnormal Child Psychology, 2, 99-116.