Sunday, April 30, 2006

ABA's Secret to Success

While reading through some commentary about Applied Behavioral Analysis (ABA) in autism, I began to suspect that I had discovered the "secret" to its reports of "success" in autism.

Part of the "secret" has to do with the way that autism is diagnosed. Even the most well-respected tests of autism rely on external behaviors of the person being tested. As a result, anything that alters those behaviors can alter the results of the test.

ABA is no different - at its core - from all of the other behavioral modification techniques used on humans and other animals. The desired behaviors are rewarded and the undesired behaviors are punished. Now, I'm sure that ABA's supporters will argue that punishment ("negative reinforcement") is no longer a part of ABA. However, the continuous repetition of the command or "physical prompting" (especially to people who are averse to physical contact) has to be considered a punishment.

So, the ABA therapist uses a slight modification of classic conditioning to get an autistic person (usually a child) to either stop doing behaviors that are considered "autistic" or get them to do behaviors that are considered "normal". If ABA manages to get an autistic person to make eye contact, respond to their name or stop flapping, their scores on the various autism rating scales will move toward less autistic (i.e. "improve").

The big question is this - does ABA actually "treat" autism - or just treat the "symptoms"? Does reducing the behaviors unique to autism equate to reducing autism? Or is it just putting on a different coat of paint?

Reducing the automatisms (e.g. "flapping") will generate improvement on standard autism rating scales, so placing the autistic person in a strait jacket should result in a similar "improvement" - right?

Wrong.

A trained psychologist would not be fooled by a strait jacket, but apparently at least a few have been fooled by its behavioral equivalent.

So, what exactly are parents accomplishing by "treating" their children with ABA? Undoubtably, some of the behavioral manifestations of autism that they (the parents, not the child) find most bothersome may be eliminated. This is good for the parents, I suppose, but is there a corresponding benefit to the child?

Not sure about that.

Again, the child may be considered to benefit because the behaviors that mark them as "different" are reduced. However, since these behaviors don't appear to be bothering the child, the "benefits" would seem to be reaped by the other members of the community who are not "disturbed". And, since many autistic children (and adults) report that their "autistic" behaviors (e.g. flapping, avoiding eye contact, etc.) are comforting, the community's "benefit" is realized at a cost to the child.

Bummer.

But, at least ABA improves something about the autistic person's ability to interact with the outside world - right?

Not sure about that.

Let's say I train my goldfish to maintain eye contact with me by only feeding him when he is looking right at me. Has this made him more able to "relate" to people? I doubt it. The same thing applies to ABA and autism. It may alter the behaviors that other people find objectionable, but it is unlikely to change anything fundamental about the autistic person, any more than training me to drool when I hear a bell ring will turn me into a dog.

Woof. Woof, woof!

I suppose that some people will argue that ABA "therapy" (I prefer to call it "training" - that seems more honest) allows autistic people to "get beyond" the obstacles that keep them "locked in" to their autistic world. That's an interesting idea, but completely without any data to support it.

Others will argue that ABA's "successes" are proof enough that it works. Well, let's look at that argument.

The original work by Ivar Lovaas seemed pretty impressive, with nineteen autistic children improved and eight "recovered". However, subsequent studies have failed to reach that level of success. The scenario where early reports (and subsequent reports from the same author or lab) are favorable but other authors (and labs) are unable to demonstrate the same results is depressingly familiar in science. It is usually a solid indicator that the early reports were in error.

Part of the problem is that a lot of the early studies of ABA compared it to doing nothing. Heck, you don't need to be a PhD psychologist to know that spending more time with any child will make them more sociable. As more people (and, especially important, people who did not train under Ivar Lovaas or his graduates) study the results of ABA, I expect that the effects on IQ and speech will continue to diminish.

So, who is benefitting from ABA? Perhaps only the therapists.


Prometheus

62 Comments:

Blogger Kristina Chew said...

And Charlie.

30 April, 2006 10:33  
Anonymous Anonymous said...

And my child.

30 April, 2006 11:00  
Blogger Prometheus said...

Ah well, at least two people (so far) haven't gotten the points of this posting ("my bad", as my son says - all too infrequently), which are:

[1] Is ABA changing anything inside the child or just modifying their behavior? And what is the "cost" to the child of modifying their responses to the outside world?

[2] Has ABA been shown to be better than a "placebo" or "sham therapy" (such as playing with the child an equal amount of time)? This becomes increasingly important when third parties (such as taxpayers) are being asked to pay for ABA.

One thing I didn't "pound" very hard was the argument by Lovaas-trained therapists that only "trained" (by whom? how long? to what standards?) therapists are able to acheive results, which rather begs the question of "says who?".

My point is not just whether ABA does or doesn't "work" but the deeper issues of whether ABA is simply the behavioral equivalent of "teaching to the test" (i.e. the autism diagnostic/scoring tests) and what the implications of this might be, ethically and scientifically.

If this disturbs you, makes you angry or just makes you think, then I have done what I set out to do.


Prometheus

30 April, 2006 12:42  
Blogger Jannalou said...

Prometheus,

This post hits on a number of the reasons why I am no longer working in the field of ABA. There are more than this, of course, and I hope to get into them sometime soon over on my own blog.

And I do not say what I do about ABA lightly. It is a very serious subject for me. I made a living working as an ABA therapist for six years. I didn't stop because I burned out, though I'd been running on empty for a while when I finally did quit. I expect the main reason I stopped was the dynamics of power inequality within the therapy setting. And I'll get into that more, I'm sure, when I blog about it.

-Janna

30 April, 2006 13:01  
Blogger Do'C said...

"So, who is benefitting from ABA? Perhaps only the therapists"

Excellent post Prometheus. I would add that perhaps certain parenting types are benefitting superficially. Parent's who believe some form of treatment is required in order to facilitate later life, may receive psychological benefit (validation) in "feeling" like they are "doing something" valuable (out of belief), especially when the list of options is perceived as small, and the requirement to "do something" is perceived as large.

This is not an advocation of doing nothing of course, education and communication are important for ANY child.

30 April, 2006 13:56  
Blogger Estee Klar-Wolfond said...

Yes, Prometheus, excellent post. Something we should all grapple with -- imposing our "order" on a child in every which way. I want to do this all the time when I consider what I want Adam to learn and how I want him to value himself in a world that either imposes a superficial value on everything and everyone. It is more amiguous territory and therefore the road less travelled.

30 April, 2006 14:38  
Blogger notmercury said...

If this disturbs you, makes you angry or just makes you think, then I have done what I set out to do.

Mission accomplished Prometheus. Made me think. 1 of 3 not bad. One benefit to ABA that is rarely acknowledged: ABA therapists make great, albeit expensive, babysitters.

I still think Lovaas was on to something with giving LSD to autistic children :-)

30 April, 2006 15:10  
Blogger ebohlman said...

A further complication is what passes as "ABA" may include a lot of perfectly ordinary, effective one-on-one teaching techniques that have had a fancy label slapped on them. From reading Kristina's blogs, I really suspect that's mostly what Charlie's getting, particularly coaching/teaching/training in language skills (and note that he's getting a few sessions a week, not the "40-hour intensives" that some Panic Parents perseverate about). I'm reminded of "EMDR" (Eye Movement Desensitization and Reprocessing), a specialized psychotherapeutic technique for treating anxiety and post-traumatic stress. It's effective, but that's because it's nothing more than a few standard, well-proven behavior-therapy techniques (primarlily exposure therapy) wrapped up in mystical trappings. There's no evidence that the trappings make it any more effective than standard therapy, but they certainly make it more expensive and make it harder to find practitioners.

So there are a couple of questions here, primarily ethical ones. First, are many of the "successes" of ABA true successes, but ones that could be achieved by much more ordinary and inexpensive means without buying into the associated belief system? Second, do we have a situation where the only practical way for a parent to find someone who will work one-on-one with their autistic kid to develop his strengths is to seach out an "ABA therapist" who hasn't drunk the Koolaid? Third, is it possible for kids to get the sort of interventions they need without also getting unnecessary conformity/cosmesis work? Well, I have no reason to doubt that it's possible for Kristina and Charlie, but how much of that is because of the nature of the particular services available where they live? (Of course, a big factor is that Kristina is trying to help Charlie's development rather than "normalize" him, but how many similar parents in other locations would run into nothing but frustration from the local service providers?) Do service providers have to buy in to the ABA belief system in order for services to be reimbursable? If so, that smells like "sweetheart deal" to me.

30 April, 2006 15:35  
Anonymous Camille said...

not mercury,

***zzztzt***
------------
I have a paper somewhere that shows that a girl who was given commands to do something (move her arm or soemthing fairly simple) and WAS NOT DOING IT, was actually sending the commands from her brain..."move now arm!". Her arm didn't move, not because her arm could never move, it's just that it was unreliable, and maybe less likely to move when under a rigid command, "MOVE YOUR ARM NOW."

The only thing an ABA therapist has is what they can see externally. The fact that this girl was commanding her arm to move could only be "seen" with an elaborate EEG set-up. This was a newish study.

It bugs me so bad because it's like, all along people have said, "if the kid doesn't obey--it's 'cuz he isn't motivated, needs a beating, wants a cookie.... is a brat...," but especially in autism, it looks like, none of their **stinking** ABA calculations and carefully noted observations apply.

There are other studies that show how autistics and other people even, learn better when they aren't required to make eye contact. Never mind that all Japanese children have autistic style eye contact. Those kids just never pay attention to grown ups when they are speaking... or it's considered rude for them to look at the adult who is speaking. (I've seen it on tape, those Japanes kids are all "autistic".)

I truly think that even if the kid seems to benefit from ABA, one day he will look around and say, "Why is it that normal Johnny next door doesn't have reams of data representing his childhood? How come no one ever comes near him with a clipboard and stopwatch and a bag of raisins or gold stars? What's so different about me? " What do parents say when their autistic child says, "Mummy, tell me aobut YOUR therapists from when YOU were three (or 10) years old."

Frank Klein says it well ... he writes: "I recently had it pointed out to me that the standard "goal" for ABA programs is to have the child instructed for forty hours a week, which makes for a pretty minimal childhood. ... Of course, forty hours a week seems like a terribly convenient work week for the ABA worker, doesn't it?"
http://home.att.net/~ascaris1/attacking-autistics.html
(he links to Michelle Dawson)
http://home.att.net/~ascaris1/mom.html
http://home.att.net/~ascaris1/more-aba.html

Also, some ABA therapists have seriously hurt autistic kids. That potential is there because of the pressure to produce, to meet those goals. Also, I think psycho-fascists are drawn to become ABA trainers ...oops, I'm not supposed to say that.

I'll slap myself now... no, that would be SIB... I'll go stand in a corner until I learn some manners.

30 April, 2006 15:59  
Blogger Jannalou said...

I truly think that even if the kid seems to benefit from ABA, one day he will look around and say, "Why is it that normal Johnny next door doesn't have reams of data representing his childhood? How come no one ever comes near him with a clipboard and stopwatch and a bag of raisins or gold stars? What's so different about me? " What do parents say when their autistic child says, "Mummy, tell me aobut YOUR therapists from when YOU were three (or 10) years old."

Here's part of my problem with what I used to do.

Frank Klein says it well ... he writes: "I recently had it pointed out to me that the standard "goal" for ABA programs is to have the child instructed for forty hours a week, which makes for a pretty minimal childhood. ... Of course, forty hours a week seems like a terribly convenient work week for the ABA worker, doesn't it?"

Here's another part of my problem. And the rabid ABAers will tell you that "a normal child is learning all the time". What indication do we have that an autistic child isn't doing the same? How do we know that they aren't processing their environment and learning from observation? WE DON'T.

Also, some ABA therapists have seriously hurt autistic kids. That potential is there because of the pressure to produce, to meet those goals.

And to conform. It's not just the kids who have to learn how to obey. People advertise for ABA therapists who are creative, but they don't really want that - they want people who will do as they're told, without question. And ideas that "break the ABA mould" are stamped out pretty damn quickly.

I still find it utterly astounding that people think they can adequately direct a chld's program when most of what they know about said child is found in the pages of a binder, reams of data. A person is not data.

I've finally begun my blog series on my experiences within the world of ABA. It should be interesting. And, hopefully, not too disturbing.

-Janna

30 April, 2006 16:30  
Blogger ebohlman said...

Never mind that all Japanese children have autistic style eye contact. Those kids just never pay attention to grown ups when they are speaking... or it's considered rude for them to look at the adult who is speaking. (I've seen it on tape, those Japanes kids are all "autistic".)

That's also true of many Latin American cultures. When large numbers of Puerto Ricans began migrating (not "immigrating" as Puerto Rico is part of the US and anyone born there is a US citizen) to New York City in the 1950s, school officials started spouting all sorts of bigoted pseudo-moralistic claptrap about how Puerto Rican parents (read mothers) didn't teach their children honesty. What they really meant was that Puerto Rican kids who were accused, rightly or wrongly, of mischief didn't look the accuser directly in the eye. But in Puerto Rico, looking the accuser directly in the eye would have been a gesture of defiance and a kid who did it could expect corporal punishment. A lot of the misperception that different cultures have radically different values comes from differences in style like this one (as another example, if you were to observe two unrelated men in Italy embracing and kissing each other on the cheeks, you would have learned precisely as much their sexual orientations as you would have if they were American women, which is to say absolutely nothing; the double standard that says that purely social, non-romantic/erotic kissing/hugging is a female-only behavior simply doesn't exist there, much to the consternation of some American tourists).

In fact, considerably more than 1 out of 166 kids in America come from such cultures, so to automatically assume that a kid who doesn't make eye contact is on the spectrum is to hear hoofbeats and think zebras.

30 April, 2006 17:20  
Anonymous Anonymous said...

ABA teaches the actions or act, but not the reasonings behind why the child is being asked to do so. it is fine if they can get the child to stop flapping or to make eye contact, but they fail to teach to the child why the child should 'want' to do this without a reward. in my area, when ABA was talked about 4 years ago, the answers were "if you want a robot for a kid, get ABA. if you want a kid with a personality, don't get ABA" also, the early stages of ABA was just that, brutal punishment, cruelty and out right abuse that resulted in major change and the requirement of further training and Certified. even today, anyone can claim to be an ABA therapist, and unless a parent checks the back ground, they'd never know they're a hig paid 'no body' trying to make a buck off a desperate parent.

my child had nevr had ABA, even if I could afford it, all that I read told me it wasn't for my child. my child was diagnosed with severe autism and was non verbal, made no eye contact. we chose O.T and had very good results. still to this day, I do not force my child to make eye contact, eat foods or wear clothing that is sensory cant take, I have no idea how it makes him feel inside to demand him otherwise. a child has a right to some discomforts, and eye contact is the least of my concerns.

anyway, the success of my child was not ABA, it was his parents first, who believed first he was a child, who happened to have autism, then private O.T and speec, good early intervention programs and mainly teachers. he has a great sense of off humor, in an inclusion class with a part time para and is fully verbal with echo'ing. my child will always have autism, no therapy or training wil change that. but how it limits me as a parent or him as a child to grow to an adult is what really matters.

just a parent

30 April, 2006 18:10  
Blogger Fore Sam said...

Prometheus;
It's good to see you finally got something right about autism. The reason Lovaas had better success earlier is because the kids had less mercury in them and could function a little better than kids today who are overwhelmed with mercury.
I haven't tried ABA but I have been trying to teach my son to swing a golf club since he could stand up. He would usually just drop it on the ground after I helped him swing it. Last year, he swung it a few times. Now, with another year of chelation under his belt, he picks up the club, grips it correctly and swings it by himself without me modeling the swing for him. Because the mercury is coming out, he is now capable of learning. No amount of teaching could ever have got him to swing that club until his brain was able to pay attention. I think your opinion on ABA is accurate. Too bad you can't accept that chelation is helping these kids.

01 May, 2006 08:19  
Blogger Prometheus said...

Trust ol' Fore Sam to see a vindication for his mercury-causes-autism obsession in anything he reads. Everything either confirms his opinion or is yet another example of the pervasive Conspiracy-to-Cover-Up-the Connection-Between-Thimerosal-and-Autism.

Delusion means never having to say "I'm wrong".

What Fore Sam is describing is a little phenomenon known as neuromaturation. Since autism is a syndrome of developmental delay (not stasis!), even the most severely affected children will continue to make progress.

And, as with "neurotypical" children, their progress will be in spurts - acquisition of a skill followed by a period of practice and mastery. In autism, these "spurts" are more dramatic, quite possibly because these children's development is so carefully monitored by their parents.

It is certainly tempting - as parents - to attribute the accomplishments of our children to something we have done for them (or to them), but the reality is that it rarely is so. Parents can, through neglect or abuse, significantly delay a child's progress, but (advertisements for "Baby Mozart" notwithstanding), there is often little we can do to significantly accelerate their progress.

This is the great draw for pseudotherapies in disorders, like autism, where improvement is unpredictable and erratic. Anything that is given or done immediately prior to a period of improvement is credited for the improvement and anything that is given immediately prior to (or is perceived to have happened in conjunction with) a period of stasis or deterioration is blamed for the setback.

And in the autism world, where there are a million and one "cures" - all of which are reputed to work "on some children" or "to some extent" - a truly "dedicated" parent (meaning a parent who has been convinced that they are a "bad parent" - or worse - if they don't do "anything it takes" to "cure" their child) may try up to a dozen or more "cures" in any one year. As a result, any improvement is likely to have been preceded by some therapeutic "intervention".

Notice how the autism snake oil salesmen (and saleswomen) have provided themselves with protective cover by saying things like "it may take weeks (or months or years) for this to work - give it time". As a result, a "treatment" given up to a year ago (and often continued in the vain hope of a "cure") will get the credit for spontaneous improvement.

No, Fore Sam, as much as I am skeptical about the merits (and ethics) of ABA, I have little doubt about the merits of chelation - it's almost certainly bunk.

You'll notice - I'm sure - that I say "almost certainly". That's because I'm a skeptic - I don't rule out the possibility that someday data may show that chelation actually does "work" for autism. I think that the chances of that happening are significantly less than my chances of winning the Powerball Lottery , but it's still a possibility.

But not one to bet on.


Prometheus

01 May, 2006 08:55  
Blogger Fore Sam said...

Prometheus;
Once in a great while, a horse that is 50 to 1 is almost a sure thing. Only a gambler capable of skeptical thinking who can throw out the favorites will find this value. Being skeptical of favorites in racing is no different than being skeptical of a profession that caused an epidemic. The medical profession poisoned our kids which makes everything else that profession has to say suspect.
Your claim that autistic kids will progress is simply false. It may have been true at one time but the amount of mercury in these young kids is keeping them from progresing AT ALL.
I wouldn't be wasting my time getting up at 4:00AM on weekends to chelate if I didn't see results. The chelation is done at low doses, slowly and safely. The improvement is very slow, imperceptible from week to week. A child who did not develop AT ALL for 7 years does not all of a sudden begin developing without a reason. Many parents would have taken this severely autistic kid who was described as a vegetable by his doctor and sent him away at four years old like I was advised to do. Like the 50 to 1 horse, my son's past performance, before he was poisoned into autism, was evidence that he was normal and I'm betting he can return to that level. You're betting that those who caused this freaking nightmare are telling the truth. How about a friendly wager? It's been seven years since Verstrtaeten told us that thimerosal caused the autism epidemic. I'll say that, for $100, thimerosal will not be used anyplace 7 years from now. The truth will come out. Is it a bet?

01 May, 2006 09:44  
Blogger Bronze Dog said...

Being skeptical of favorites in racing is no different than being skeptical of a profession that caused an epidemic. The medical profession poisoned our kids which makes everything else that profession has to say suspect.

And Fore Sam ignores everything that defines skepticism. We talk about things in terms of evidence, not authorities.

He also, once again, proclaims his conclusion without providing any. Repetition isn't going to convince us Fore Sam. Evidence will. Do you have any?

Your claim that autistic kids will progress is simply false. It may have been true at one time but the amount of mercury in these young kids is keeping them from progresing AT ALL.

That claim may be negative, but it is so extraordinary, I'd need to see some attempt to prove it. He'd have to unprove all the anecdotes I've heard to the contrary, as well as the raw data. And I have a feeling he made up the claim to render his side unfalsifiable.

I wouldn't be wasting my time getting up at 4:00AM on weekends to chelate if I didn't see results.

And we're back to Fore Sam's old Cartesian circle. He wouldn't do it if he didn't see results. He wouldn't be seeing results if it didn't work. There's no chance he could be mistaken, and there's no chance there's another cause. Nope. No way. Especially not the one that he says never happens.

A child who did not develop AT ALL for 7 years does not all of a sudden begin developing without a reason.

And there's no possibility of Fore Sam misremembering as a result of indoctrination. Nope. His memories are unchanging.

You're betting that those who caused this freaking nightmare are telling the truth.

Prove that they caused it. Or is the burden of proof too heavy?

01 May, 2006 10:35  
Blogger Fore Sam said...

Bronze Dog;
The thing you missed in your idiotic Cartesian circle argument is that I would have quit if it wasn't working. I wouldn't have kept this up for two long years if there were no results. You aren't observing the kid so you have zero basis for your obnoxious remarks.
You always avoid the evidence, Mr Bronze Dog. You don't discuss Verstraeten, or Simpsonwood or Frist and you persist in calling all parents liars who offer proof that chelation works. All of those things are evidence whether you like it or not. 1943 is evidence. The spike in autisn directly correlates to the HepB vaccine in 1991 and that is evidence. China is evidence. A few rare cases of autism in China before 1999 does not wash away that increase that is directly attributable to thimerosal. The 4 to 1 ratio of boys to girls due to testosterone is evidence. Add it all up, plus a bunch of other stuff that I don't feel like spelling out for you again, and it is indisputable. If you had a kid with autism, you might open up your closed mind and learn to think critically about the scientists who have a vested stake in covering up their mistake. I can only hope for the sake of the children that you other dopes who do have kids with autism wake up to the truth of the matter soon while you still might help your kids.

01 May, 2006 11:11  
Blogger Bronze Dog said...

The thing you missed in your idiotic Cartesian circle argument is that I would have quit if it wasn't working.

It's your circle, and no, I didn't miss it. Read it again, and try to bear in mind that human senses are fallible.

You always avoid the evidence, Mr Bronze Dog. You don't discuss 1943 is evidence. The spike in autisnVerstraeten, or Simpsonwood or Frist and you persist in calling all parents liars who offer proof that chelation works.

Verstraeten: Why bother discussing what's already been dealt with?

Simpsonwood: It doesn't say anything. If you'd like to discuss it, give me page numbers to look at.

Frist: If you're talking about the politician: Please don't employ the Chewbacca Defense

"Liars": Try reading my posts once in a while, instead of scanning for key words. I've never called them liars, and I think you know it.

1943 is evidence. The spike in autisn directly correlates to the HepB vaccine in 1991 and that is evidence. China is evidence. A few rare cases of autism in China before 1999 does not wash away that increase that is directly attributable to thimerosal.

Show me. Don't tell me.

The 4 to 1 ratio of boys to girls due to testosterone is evidence.

It's also evidence for a genetic explanation.

Add it all up, plus a bunch of other stuff that I don't feel like spelling out for you again, and it is indisputable.

You haven't even shown me the bits to add up, yet.

"Indisputable" is a word for fanatics.

If you had a kid with autism, you might open up your closed mind and learn to think critically about the scientists who have a vested stake in covering up their mistake.

You're the one with the closed mind. You're closed to the possibility of being a fallible human being, with fallible memories and perceptions. I'm open-minded, but you prefer obfuscation and propagandizing over discussion of the evidence you refuse to show.

There's also a double-standard of yours: When I apply critical thinking (pointing out logical fallacies), you whine and complain, and treat it as if critical thinking and logic are evil. I'm willing to apply critical thinking to the scientists, and I do. The problem is that you don't provide any reason to reject my tenative conclusion: You don't discuss the issue, you chatter, you imply, you obfuscate, you change the subject. You do just about everything except discuss the evidence.

I can only hope for the sake of the children that you other dopes who do have kids with autism wake up to the truth of the matter soon while you still might help your kids.

Then direct me to someone on your side who can actually discuss the issue, instead of beating around the propaganda bush.

01 May, 2006 11:39  
Blogger jypsy said...

Camille said "Frank Klein says it well ... he writes: "I recently had it pointed out to me that the standard "goal" for ABA programs is to have the child instructed for forty hours a week, which makes for a pretty minimal childhood. ... Of course, forty hours a week seems like a terribly convenient work week for the ABA worker, doesn't it?""

In fact I was the person who pointed that out to Frank. It was one of our very first contacts.

01 May, 2006 13:02  
Blogger Fore Sam said...

Bronze Dog;
Calling evidence propaganda will not wash it away. You've seen the links a hundred times and you probably have them neatly saved yourself. I don't happen to be an anal retentive link saver. I read the stuff and try to remember what's worthwhile.
LOL, you call the 4 to 1 ratio genetic. Yup, it's genetic, boys are genetically programmed to produce testosterone. That's a good joke.
If I had a closed mind, I'd just listen to my doctor tell me that the mercury debate was nonsense. And, my kid would not have progressed AT ALL.
You call parents liars all the time. You just use the word anecdotal instead of the word liars. If you had half a brain, you'd see that parents are the only ones interested in helping the kids because the doctors don't want to admit their fallibility and they're just a bunch of scumbags, letting kids suffer when they know how to cure them.
BTW, pointing out logical fallacies is not evidence of critical thinking. All it is a way to win a debate. It has nothing to do with truth which is the only thing that matters when it comes to the welfare of the children. That's how I know I'm talking with liars and criminals involved in the coverup when I start hearing logical fallacies instead of truth.

01 May, 2006 14:01  
Blogger Prometheus said...

Fore Sam,

It's always fun when you stop by - promise me that you won't ever change, OK?

For about the 9th or 10th time (I've lost track), saying that somebody is wrong or mistaken is not the same as calling them a liar. In case you don't know the difference, let me outline it:

Lying: communicating something that you know is not true.

Being wrong: believing or communicating something is that is not correct with the belief that it is correct.

Being mistaken: see "being wrong" above - a more socially polite way of saying the same thing.

You see, Fore Sam, there is a difference.

As for the rest, I've been advised by friends in the Psychology Department that it is futile to try to reason someone out of a delusion or obsession.

Let's just leave it at this: your faith in the "data" you present is not informed by any ability to independently understand it (or even confirm it). In other words, these are not your ideas, they are the ideas of authority figures that you trust. You are just parroting them.

I am under no obligation to trust these same people and, in fact, I find their explanations full of contradictions and "hand-waving". More smoke and heat than light, as they say. The fact that you do not see their limitations is simply a reflection of your willingness to uncritically believe what these folks say because it fills a psychological need somewhere inside you.

You may wish to wallow in these fanciful ideas, Fore Sam, but I don't. No amount of wishful thinking or misdirected anger is going to find the cause(s) of autism or its treatment(s). In fact, people like you and the "practitioners" you promote are doing more to obstruct research on autism than any "government conspiracy" could ever do.

Come back when you have some data - or when you wish to remind us of the ignorance we're fighting against.

Want a cracker?


Prometheus

01 May, 2006 16:11  
Blogger Bronze Dog said...

Calling evidence propaganda will not wash it away.

Complete lack of understanding, Fore Sam. Pay attention. What you type isn't evidence. It has only the faintest connection to the evidence, most of which doesn't say what you say it says.

You've seen the links a hundred times and you probably have them neatly saved yourself. I don't happen to be an anal retentive link saver.

1. I don't keep that many links. Mostly I just deflate your non-linking posts of their propagandistic sting.

2. If you don't feel like showing people the evidence, don't bother posting. We're skeptics. We rely on information. If you're the advocate, and you don't post links to evidence, you're engaging in nothing.

LOL, you call the 4 to 1 ratio genetic. Yup, it's genetic, boys are genetically programmed to produce testosterone. That's a good joke.

Apparently you don't know how X and Y chromosomes can pass on flaws in different proportions to gender. Perhaps you should spend some time researching why hemophilia was called "the royal disease". Autism might have some genetic similarity in heredity. Of course, that's all speculation on my part. But until you can show me proof of alien spacecraft, my weather balloon hypothesis is the most reasonable.

If I had a closed mind, I'd just listen to my doctor tell me that the mercury debate was nonsense. And, my kid would not have progressed AT ALL.

1. Strawman.

2. Do you possess some psychic ability to see into alternate timelines?

You call parents liars all the time. You just use the word anecdotal instead of the word liars.

I'm seriously beginning to wonder if you got a zero on your SAT verbal. Read Prometheus's post, above. Re-read it a few dozen times if necessary.

If you had half a brain, you'd see that parents are the only ones interested in helping the kids because the doctors don't want to admit their fallibility and they're just a bunch of scumbags, letting kids suffer when they know how to cure them.

If you had half a brain, you'd see that I'm very interested. You are not. You're just shouting your conclusion over and over, and ignoring all my requests for evidence. You're the advocate. I'm the skeptic. You're the one with the burden of proof, so get to work.

BTW, pointing out logical fallacies is not evidence of critical thinking. All it is a way to win a debate. It has nothing to do with truth which is the only thing that matters when it comes to the welfare of the children. That's how I know I'm talking with liars and criminals involved in the coverup when I start hearing logical fallacies instead of truth.

Boy, are you backwards. You're the wikipedia definition of "sophistry." And you're the one committing those logical fallacies. You don't even know what my arguments are. The Chewbacca Defenses you pull are what are designed to win an argument, rather than find the truth. And that, is the definition of sophistry: Winning an argument at all costs, rather than searching for the truth.

Stop your appeals to emotion, your barking-at-thunderstorms post hoc fallacies, and actually discuss the issue instead of skimming for key words and posting repetitive non-arguments. Right now, you're no different in style than UFOlogists, psychics, Creationists, lawyers, and politicians. Argue like a scientist. Argue like a human being.

02 May, 2006 06:08  
Anonymous Gray Falcon said...

Prometheus, comparing Fore Sam to a parrot was a bit cruel. It suggests someone who is incapable of understanding, just repeating words without knowing anything. I know for a fact that parrots, like many animals, are much smarter than humans give them credit for, and can actually learn to understand a few words. Fore Sam's level is more like that of a primitive AI like ELIZA.

02 May, 2006 06:22  
Blogger Fore Sam said...

Prometheus;
Thanks for admitting your side is wrong. If you had any confidence in what you say, you'd have taken my wager.
Granted, I learned what I know about autism from honest scientists like Deth, Geier and Cutler. Since Deth educated all of us about exactly how mercury causes autism, it is just a matter of picking up those facts. The first poor guy who got bit by a rattlesnake didn't know it was poisonous beforehand either. The rest of the world learned of the danger from his misfortune. It's too bad you're such a slow learner. Your child may benefit from you getting the facts straight. Tell me again why Pharma felt it was worthwhile to donate $20 million to Bush, will you?

02 May, 2006 06:29  
Blogger Fore Sam said...

Bronze Dog;
Here's all the science you need to know. Give a kid too much mercury and cause autism. Remove the mercury and give the kid back his normalcy. I can't make it any simpler for you. Want proof? Wait until Bill Frist is an old, dying man like "Deep Throat" and maybe he'll tell us why he kept sneaking protection into bills for his pals in Pharma. In the meantime, we'll just cure the kids whose parents don't have their heads up their asses.

02 May, 2006 06:37  
Blogger Bronze Dog said...

Here's all the science you need to know. Give a kid too much mercury and cause autism.

Stop acting like those straw men doctors you like to knock over. How do you know that? If you can't answer that, you're not doing science, you're preaching a faith.

Remove the mercury and give the kid back his normalcy.

How do you know that?

Want proof? Wait until Bill Frist is an old, dying man like "Deep Throat" and maybe he'll tell us why he kept sneaking protection into bills for his pals in Pharma.

Of course, Bill Frist has nothing to do with the matter, thank you very much for demonstrating your inability to remain on topic. And, IIRC, the bills were designed to prevent scaremongers like you from compromising our national health by going litigation-happy on flimsy evidence and jury-targeting logical fallacies designed to get them to rule against scientific evidence.

In the meantime, we'll just cure the kids whose parents don't have their heads up their asses.

Show me evidence that you're actually performing a cure, and not misattributing the real causes of improvement.

02 May, 2006 07:14  
Blogger Prometheus said...

Fore Sam,

Maybe I missed something, but what does whether thimerosal is used anywhere have to do with whether or not it causes autism? If you'll think back, I'll be willing to wager that you can't find a single instance where I said that putting thimerosal in vaccines was a good thing to do.

What I have consistently (and successfully) argued is that you (and many others) have failed to prove that thimerosal causes autism. Now, if you and your fellow lemmings (see: Chicken Little) manage to drum up enough fear to get manufacturers to stop using thimerosal, that is an question of fear, not reason.

I also can't remember saying that "my side" (I suppose by that you mean the side of rationality and science) was wrong. If you read the post, you'll see that I am raising some issues of scientific method and ethics. These are the same sorts of issues I raise with the "honest scientists" you quote.

And speaking of your "honest scientists" - there you go again with your "honest" vs "liar" obsession. You know, don't you, that someone can be honest as the day is long and still be dead wrong. I have no doubt that Fleishman and Pons truly believed that they had found cold fusion, but that didn't keep them from being wrong.

That's the problem with trust, Fore Sam - it's no way to do science. I don't assume that you are lying to me when you say that your son "...did not develop AT ALL for 7 years...", I just find it highly unlikely that your son made zero neurological progress for seven years and still got diagnosed as autistic. If you look at even the abbreviated diagnostic criteria, you'll see that absolute failure to progress at that age wold eliminate autism as a diagnosis. This leaves me with three possibilities:

[1] You have accurately reported you son's progress and, therefore, your son does not have autism or anything that could possibly be confused with autism.

[2] You have not accurately reported your son's progress but have, instead, reported your recollection of his progress, which is at variance with his actual developmental history.

[3] You are lying.

Unlike you, I feel that I need to have evidence of an intent to deceive before I pick option [3].

And, given other statements you have made about your son's history, I find it highly unlikely that his neurological development stopped at one or two years of age - that's just not consistent with what you have said before (scratch option [1]). That leaves me with option [2] - that you are telling what you perceive to be the truth, but that your report is simply inaccurate.

You also need to try a bit harder to keep on track, Fore Sam. Dragging politicians like Bill Frist, Geoerge Bush (or, for that matter, Dave Weldon or Dan Burton) into the matter is less than irrelevant.

Members of Congress (and other politicians), regardless of what their profession was prior to election, are engaged in only one mission: getting re-elected. And, as history has shown, they will embrace anything - no matter how crazy and irrational - if they think it will give them the "edge" they need.

So quote me no politicos, Sam - I'd rather hear from people who are free to speak their minds.

Thanks for stopping by!


Prometheus

02 May, 2006 09:29  
Blogger Fore Sam said...

Prometheus;
You're an intelligent guy. You understand the one goal of politicians is re-election. So, the bribe paid to Bush is no real reflection on Bush since all politicians take bribes. It is, however, a reflection on Pharma. Why do they need to pay that bribe if they have not done anything wrong? You and I both know that they would lose everything they have if our lawsuits were allowed to go forward, especially if the statute of limitations didn't prevent most of us from seeking compensation. I think most rational people would see those bribes as an admission of guilt. It might be interesting to see how much bribery Pharma was engaged in before Verstraeten told us that thimerosal caused the autism epidemic.
I'm not sure if you are failing to differentiate between genetic autism and mercury poisoning in your discussion about progression. Of course, almost all autism is a misdiagnosis for mercury poisoning. So, in that context, you are correct in claiming my son does not have autism. The poisoning did cause his progression to cease at about one year of age. I suppose if you hadn't seen it every day, you would find it hard to believe. There was no progression for 7 years until chelation started. He only grew physically, so could spin larger things and spin himself faster in circles and smear feces higher on the walls.
It is absolutely relevant when Frist protects criminals when he should be helping to cure our kids by telling everyone the truth instead of helping to hide it.

02 May, 2006 10:29  
Blogger Fore Sam said...

BronzeDog;
Since you opt not to believe me, I guess you'll have to go out and meet some of the kids who've been cured. I told you about them but you keep telling me to prove it. That's simply calling me a liar and serves no useful purpose. I only want to help parents learn that their kids can be helped. All you want to do is shout "Prove it" at me. All you're doing is trying to harm kids by keeping their parents ignorant. Why don't you do something useful like asking for safety testing on thimerosal?

02 May, 2006 10:43  
Blogger Bronze Dog said...

Since you opt not to believe me, I guess you'll have to go out and meet some of the kids who've been cured.

Once again, you ignore everything I've said about double-blind control studies and the reasons for their necessity. It's convenient for you to forget about all that, isn't it?

I told you about them but you keep telling me to prove it.

And you ignored each and every criteria science requires. If I went with your standards, homeopathy, Q-Ray, chakra soulmelds, and all that absurdity would be just as effective. Chelation is no different than any of them in those regards.

I only want to help parents learn that their kids can be helped.

I've grown to doubt that.

All you want to do is shout "Prove it" at me.

I want to learn the truth. I can't do that if you can't discuss good evidence. You're the one holding up the works by not living up to the burden of proof. You don't even know what good proof is.

All you're doing is trying to harm kids by keeping their parents ignorant.

Way to straw man. Did you learn that from George Bush? Try not demonizing your opponents, and arguing with their actual positions, not the ones that are quick and easy to refute. That way leads to the dark side.

Why don't you do something useful like asking for safety testing on thimerosal?

Oops, you did it again.

02 May, 2006 12:26  
Blogger Prometheus said...

I think that by now it is painfully clear to everyone who has not drunk deep of the mercury-causes-autism/autism-is-mercury-poisoning Kool-Aid (see: Jonestown) that Fore Sam has gone "around the bend" on this one.

I suppose that campaign contributions could be seen as a species of "bribes", but I think that the claim that they are evidence of guilt or conspiracy is probably over the line into clinical paranoia. It makes me wonder what Fore Sam's criteria for "rational person" might be.

I think that Fore Sam has gotten a bit too lathered up at this point, so I'm going to ask people to ignore his posts for a day or so in order to give him time to compose himself. We can return to our (futile) efforts to show him the light of reason once his brain has cooled.

One final point, though - Fore Sam, you might want to consider the concept of "white space" in your writing. "White space" is the spaces, extra lines and indentations that good writers use to set off their ideas and give their readers some visual reference points.

By failing to use "white space", you give the written impression of someone speaking rapidly without taking a breath. Which, based on the content of your writing, may be exactly how you express yourself. However, if that isn't the impression you wish to give, then consider the use of "white space".


Prometheus.

02 May, 2006 12:42  
Blogger Fore Sam said...

Bronze Dog;
One more time, just for you. A person may be cured of an illness without a DBCS. I'll bet you've overcome a few common colds without the benefit of a DBCS. I promise not to call you a liar if you claim as much.

02 May, 2006 13:09  
Blogger Fore Sam said...

Prometheus;
Using common sense to interpret the reason for bribes is not paranoia. Some of us are also capable of using common sense when it comes to dealing with injecting known poisons into babies.
Common sense tells one that removing the poison is a good idea. Sometimes common sense isn't so common, as evidenced on all neurodiverse blogs.

02 May, 2006 13:13  
Blogger Bronze Dog said...

More straw men. More use of vocabulary without knowledge of its meaning. Misuse of "common sense". Loaded language. Hint of the "wisdom" of repugnance. Argumentum ad nauseam.

And, of course, he avoids actual discussion.

02 May, 2006 13:51  
Blogger Fore Sam said...

BD;
Since you don't disagree with anything specific that I said, can I assume you agree that removing the poison is a good idea?

02 May, 2006 13:53  
Blogger Bronze Dog said...

When you use "poison", you're using the propaganda technique of "intentional vagueness." I am unable to agree or disagree with a statement that has an undefined word. Define how you use the word "mercury" while you're at it.

02 May, 2006 14:04  
Blogger Fore Sam said...

BD;
Hold on while I find some pliers to pull some teeth. The ethyl mercury contained in thimerosal is the poison I am referring to, as you well know.

02 May, 2006 14:53  
Blogger Bronze Dog said...

What evidence do you have that ethyl mercury is poisonous in the amounts given?

02 May, 2006 15:04  
Anonymous Anonymous said...

I don't know which planet you are from. Where I come from (the earth), my son was throwing toys on other kids and parents in the waiting room during a doctor's visit and I am sure it's a great concern. I am sure ABA will address this concern. What solutions do you have to stop my child throwing stuff on other people when I take him out.

02 May, 2006 15:35  
Blogger Fore Sam said...

BD;
The CDC tells us only one or one/half microgram is safe. Ergo, 25, 50 or 75 micrograms at one time is not safe. There was no autism before thimerosal was invented. The autism epidemic began when they increased the TCV's. Aside from the few rare cases of autism you dug up in China, they ESSENTIALLY went from no autism to 5 million cases in 6 years due to the use of thimerosal.

Anon;
ABA may address your concern. Chelation will probably cure it.

02 May, 2006 15:47  
Blogger Prometheus said...

Fore Sam,

You repeatedly ask, "Is it a good idea to inject babies with poison", "... I assume you agree that removing the poison is a good idea..." and other statements of that sort. Are you aware that these "questions" are no different from "Have you stopped beating your wife?"

In short, your "question" carries some implied assumptions, which your readers may not agree with. Let me help you to understand them - we'll use one of your favorites:

"Is it a good idea to inject babies with poison?"

Well, on the surface, this seems like a fairly straightforward question - after all, nobody thinks it's a good idea to inject babies with poison, right?

But then we have to ask, "What poison are you talking about?" because, as everyone knows, many substances commonly believed to be safe are toxic at higher doses and many toxic substances are innocuous at lower doses. Table salt is lethal at high doses and cyanide - a deadly poison found in peach pits and apple seeds - is perfectly safe at low doses.

After identifying the "poison" you have in mind - don't worry, we all knew it was thimerosal - then we have to ask about the dose. And this is where you start to run into some trouble, because the dose administered has not been shown to cause damage in humans, let alone cause autism.

Finally, we have to deal with the blatantly emotional tone of the question, which shows clearly what your intended answer is. After all, would you have said that someone was injecting their child with poison when they give their child EDTA, DMPS or Lupron?

Yet each of these is highly toxic - in the right dose. In fact, two of the three (and maybe all three) are toxic at doses not much about the effective dose.

So, we have established that you like to ask "loaded" questions, that you are exceedingly hypocritical and that you still haven't provided any data to support your statements.

Have you stopped beating your wife?

Prometheus.

02 May, 2006 15:49  
Blogger Bronze Dog said...

The CDC tells us only one or one/half microgram is safe.

Where did they say this?
What evidence did they base this upon?

I'll forego commenting on the rest of Fore Sam's post, since it's probably irrelevant until this particular fact has been established.

02 May, 2006 16:43  
Anonymous Anonymous said...

Anonymous says,

I don't know which planet you are from.

Which planet anyone is from originally is irrelevant.

Where I come from (the earth),

Ah, a native, good to meet you.

My son was throwing toys on other kids and parents in the waiting room during a doctor's visit and I am sure it's a great concern.

Most earth kids throw stuff at some point, is this your first? Were they pretty cool things to throw, or was it successful at getting attention?

I am sure ABA will address this concern.

What concern? That he could become great pitcher someday, or concern that his behavior needs a little guidance (like all earth children)?

What solutions do you have to stop my child throwing stuff on other people when I take him out.

Here's a thought. Ask yourself the same question. What solutions can you come up with to lead to appropriate behavior from your child? What do you think most successful parents do?

I'll give you a hint, step 1: Understand the behavior.

02 May, 2006 21:34  
Blogger Fore Sam said...

Sorry Prometheus;
The dose has been shown to cause autism. Mark Geier gave us that proof after Verstraeten gave it to us. Verstraeten tried to alter the data in a silly attempt to hide the truth to shelter Pharma from lawsuits and to help his bosses at the CDC protect public confidence in the vaccine program.
Chelation is making kids return to normalcy and your assertion that this could be explained by normal development is pure nonsense and you know it.
Your wife beating analogy is not appropriate since, without rewriting Evidence of Harm, you've already seen all the proof. You just choose to keep fightimg a losing battle. Why you want to deny the truth is anybody's guess.

BronzeDog;
LOL, you continually try to evade the questions by asking obnoxious questions when you already know the answers. Go to the CDC website and look it up for yourself if you truly don't already know.

03 May, 2006 04:44  
Blogger Bronze Dog said...

I couldn't find anything at the CDC website about one microgram of ethyl mercury being poisonous.

My guess is that my question is obnoxious because you can't answer it. Prove me wrong by providing a direct link.

And riiiiiiight. I'm being evasive by challenging one of your unsupported statements upon which the entire issue rests. Asking for evidence instead of bringing in irrelevant politicians is being evasive. Got it.

Geiers: Show me the paper.
Verstraeten: Show me the paper.

If you can't do that, you might as well be making it up, since you have a habit about misrepresenting the contents of papers, like every altie does with the Simpsonwood document I've seen.

03 May, 2006 05:56  
Blogger Fore Sam said...

Bronze Dog;
Show me your brain. There's no evidence that it exists here.

03 May, 2006 06:26  
Blogger Bronze Dog said...

Only because you ignore the actual content of my posts. Now, either show me where the CDC says one microgram of ethyl mercury is poisonous, or stop saying that. As I've said to so many psychics, UFOlogists, Bigfoot believers, etc: Put up or shut up.

If you have no intention of backing up a verifiable claim you make, don't make the claim. My bet is that the CDC said no such thing, and you're trying to shift the burden of proof onto me, just like psychics claim that the evidence is out there if I just Googled it. Sorry. I've Googled it. No good results.

Stop chattering and show us your homework.

03 May, 2006 06:36  
Anonymous Anonymous said...

Prometheus said:
"This is the great draw for pseudotherapies in disorders, like autism, where improvement is unpredictable and erratic. Anything that is given or done immediately prior to a period of improvement is credited for the improvement and anything that is given immediately prior to (or is perceived to have happened in conjunction with) a period of stasis or deterioration is blamed for the setback."

Yes, yes, yes. My youngest has Down Syndrome and just like any child he will plateau and then suddenly lead ahead in development. I'm not sure that his jumps are anymore dramatic than my other children's but the plateaus are so much longer they seem so dramatic.

As in autism, the DS world has it's share of miracle "cures", many of them based on massive doses of vitamins & minerals. They all claim improvement in IQ & behavior and some even claim a change in appearance. And the controversy is as heated, there is so much at stake. I've been on web lists and forums where propents all but accuse sceptics of abusing their children (and visa versa). Most of these thearpies are fairly expensive and require a big commitment from parents and if therapy fails it's the parent's fault.

Notice how the autism snake oil salesmen (and saleswomen) have provided themselves with protective cover by saying things like "it may take weeks (or months or years) for this to work - give it time". As a result, a "treatment" given up to a year ago (and often continued in the vain hope of a "cure") will get the credit for spontaneous improvement.

Unfortunately, all too true.

BTW, thank you for your blog, interesting reading and I usually learn something.

Anne

03 May, 2006 08:24  
Blogger Bronze Dog said...

As in autism, the DS world has it's share of miracle "cures", many of them based on massive doses of vitamins & minerals. They all claim improvement in IQ & behavior and some even claim a change in appearance. And the controversy is as heated, there is so much at stake. I've been on web lists and forums where propents all but accuse sceptics of abusing their children (and visa versa). Most of these thearpies are fairly expensive and require a big commitment from parents and if therapy fails it's the parent's fault.

Good example. It's easy for parents to misjudge the behavior of their children: They've got a lot at stake, so it's no suprise that parents can fall for wishful thinking, confirmation bias, etc. Popping out a baby does not transform one into an infallible judge and record-keeper of human behavior. That's why double-blind control studies are important: They're designed to filter out those human failings.

03 May, 2006 08:46  
Blogger Joseph said...

The original work by Ivar Lovaas seemed pretty impressive, with nineteen autistic children improved and eight "recovered".

It needs to be emphasized that Lovaas did not use a randomized control group on placebo. No replications to date have done either.

(And I'll just ignore John's ongoing nonsense).

03 May, 2006 12:28  
Blogger Robert P said...

prometheus,

This is an ongoing discussion I have had with others. It comes down to something you noted, what is autism? Or, for this point, what is ASD and what is Asperger's? They are all defined, not by genetic markers like Fragile X or Down's, but through behavioral tasks. No matter if they are several days in the taking, they are behavioral tasks that are susceptible to misdiagnosis and personal interpretation.

This is the reason there are so many adult ASDians showing up as the parents of ASD kids. They went through life, some might have thought them weird, but they coped and in many cases adapted without knowing why they were adapting. Now that their kids are being diagnosed, they are being retroactively diagnosed.

The ongoing discussion, I got sidetracked, is this. Take an ASPY boy at age 3 and give him all the Axxx tests. It comes out that he has Asperger's. Now, let him go through TEACCH or ABA or RIT or just life for 10 years. At this age he has learned to interact with children and to hide his occasional repetitive movements. If tested now by a naive professional, he gets a diagnosis of no Asperger's, maybe PDD-NOS, maybe nothing.

Is he cured? Of what? Certainly not the genetic mechanism that causes Autism. Of the symptoms? Sure.

So, would you call that Asymptomatic Autism?

03 May, 2006 13:11  
Anonymous Rolf Marvin Bøe Lindgren said...

Prometheus,

attacking ABA because of weaknesses in Lovaas therapy is akin to attacking physics when bridges collapse.

Behavior analysis is an attempt at the scientific study of the effects that changes in the environment have on organisms. It's much more involved than it sounds. Contrary to myth, behavior analysis recognizes the importance of cognitive processes (as laid out in Skinner's classical 1945 article _The operational analysis of psychological terms_).

Furthermore, behavior analysis is non-reductionistic, stressing that behaviorally based and neurologically based explanations of behavior are equally true but are at different levels of explanation. Skinner speculized that behavior analysis would once be replaced by physiology.

ABA is a set of one-size-fits-all interventions based on behavior analysis. They should properly be viewed as a set of technologies for behavior change in constant transition based on the results of new research. Unfortunately, when things are formalized they tend to become static. But ABA not is not what Lovaas therapy was in 1988.

Yes, spending time with kids can help improve their social functioning, and the mechanisms involved can fully be described within the framework of behavior analysis. So can any effect of the environment (including drugs and conversation). Very simplified, the reasoning goes like this:

The entire organism is involved in behavior (thinking and feeling are behaviors and can be treated (but by no means simply) as such). Autism (as any class of operants) is (from the perspective of behavior analysis) what you can observe. The structural differences in the brain associated with autism are not the cause of the autism, they are part of it because they are involved in autistic behavior. If behavior be changed (through _any_ intervation) so that even you would agree that the autism is less severe, there has also been a change in the body. You would only, I assume, be
satisfied if there were a real change in the brain structures that you argue _cause_ autism. I don't agree, due to differences in opinion of what a _cause_ is. My understanding of what a cause is helps me clarify matters when I design interventions (and as an organizational psychologist, I don't treat autism. But I talk with those who do).

We both agree that without the relevant structural changes in the brain, there would be no autism.

Behavior analysis, like any other scientific discipline, is hard to understand. It's contrary to common sense in many ways. I apply behavior analytic techniques mainly because they work but also because the theoretical basis is sound. Unfortunately, understanding behavior analysis is hard work. You have demonstrated, as far as I can gather, that you have made quite an effort in understanding the arguments of the mercury assertion supporters and the chelation assertion supporters. I wish you'd committ a similar effort in understanding the reasoning behind ABA. If you had, you would not have posted such nonsense as that negative reinforcement is the same as punishment and that ABA is based on a slight modification of classical conditioning. I'd recommend talking to a professor of behavior analysis (I can easily put you in touch with a few) and/or reading Baum's excellent _Understanding Behaviorism_ (it's available from Amazon).

There's a lot more. I can't provide a meaningful account of behavior analysis in a few paragraphs just as I can't provide a meaningful account of quantum electrodynamics in a few paragraphs. Behavior analysis is surrounded by myth and in order to understand it one should go to the sources. Secondary material is generally misrepresentative. See eg.

http://www.findarticles.com/p/articles/mi_qa3645/is_199704/ai_n8763406
http://www.findarticles.com/p/articles/mi_m2843/is_1_28/ai_111897963
http://www.bfskinner.org/SHBtext.pdf

03 May, 2006 16:03  
Blogger Prometheus said...

To Rolf Marvin Bøe Lindgren:

To begin with, my "attack" on ABA was not supported solely by the weaknesses in Lovaas' study. However, since Lovaas' study has shown the most impressive effect of ABA, it is relevant to discuss its weaknesses - which are legion.

You state that, "...If behavior be changed (through _any_ intervation) so that even you would agree that the autism is less severe, there has also been a change in the body." I suppose that is true, at least on the microscopic level, since all behavioral changes are accompanied by changes in neuronal connectivity.

However, the real point of my posting is whether changing behaviors changes anything in the autistic person that makes their life more fulfilling, more pleasant, easier to negotiate...etc.

In other words, does ABA make life better/easier/more fulfilling for the autistic person, or just for the people around the autistic person? This is an important distinction, and one that ABA does not appear equipped to make.

At its root, the question is more philosophical than biological. Most parents agree that children's behavior has to be altered from its native form in order to allow the child to function in society. This alteration in behavior is accomplished - usually instinctively - by the parents. However, a growing number of autistic people are reporting that the behavior-modification techniques used in ABA (even without the physically and mentally abusive ones used by Lovaas) are aversive and perhaps even cruel.

This brings up the question: Where do we draw the line between the normal process of "molding" a child's behavior to socialize them and cruelty or abuse? This, I think, is not a question that science can answer.

The second issue in my post is whether ABA constitutes a more effective therapy than simply playing with the child. This would be a moot question if not for the growing numbers of articles by ABA therapist-researchers insisting that "poorly-trained" therapists or lay-therapists cannot generate the reported benefits of ABA.

If ABA could be performed by the parents, its efficacy would not be such a question. However, with ABA therapists charging for their services and the reports that a certain minimal number of contact hours are required (cited between 16 and 40 hours a week), the efficacy of ABA is very much an issue.

Your comparison between behavior analysis and quantum electrodynamics is intriguing but falicious. QED has been extensively tested and has survived those tests well. Behavioral analysis has not been extensively tested, nor can it be tested to the degree and precision that QED has.

In addition, the core tenets of behavioral analysis as put forth by experts in the field are hardly relevant to the discussion. As you pointed out, ABA has strayed far from the "true faith", so it is more relevant to parents to discuss how ABA is practiced in the community, which is a true "hodge-podge" of myth and mysticism.

Finally, you object to my equating "negative reinforcement" - inside inverted commas, to alert you to the non-standard use - with punishment. However, this was how some of the original work by Lovaas described yelling at children and striking them - "negative reinforcement" and "aversives" - nice euphamisms. Additionally, what may seem like negative reinforcement on one side of the table may seem a lot like punishment from the other side.

I understand that your perspective of behavioral analysis - based on what sounds like a long period of study or practice - differs greatly from mine. I hope that you will understand that my point is not to broadly condemn behavioral analysis, but to question how a small part of it - ABA - is currently being practiced in the community.


Prometheus

03 May, 2006 17:05  
Anonymous anonimouse said...

Foresam spewed:

You just choose to keep fightimg a losing battle.

Yes, John, you do.

04 May, 2006 06:54  
Blogger Jannalou said...

Behavior analysis, like any other scientific discipline, is hard to understand. It's contrary to common sense in many ways. I apply behavior analytic techniques mainly because they work but also because the theoretical basis is sound. Unfortunately, understanding behavior analysis is hard work.

Actually, to me it makes absolute perfect sense. It's not as complicated as people like to make it out to be. Of course, I have what's known as a "natural talent" for ABA.

In other words, does ABA make life better/easier/more fulfilling for the autistic person, or just for the people around the autistic person? This is an important distinction, and one that ABA does not appear equipped to make.

It really, really isn't. People seem to assume that because having an autistic child is difficult for the parents, the child must also be in distress, so eliminating the autistic behaviours must improve the life of the child as much as it improves the lives of the parents.

Of course, we all know what happens when one assumes...

This brings up the question: Where do we draw the line between the normal process of "molding" a child's behavior to socialize them and cruelty or abuse? This, I think, is not a question that science can answer.

I've wondered that myself, just in my own life as an undiagnosed ADDer. How much of the conditioned reactions I have to various things (which are the same as those of someone who was abused) are a result of "abuse" that wouldn't have been experienced as abusive by someone with a more normal neurology? I think it's foolish to expect anyone to be able to raise a child without causing some scarring.

The second issue in my post is whether ABA constitutes a more effective therapy than simply playing with the child. This would be a moot question if not for the growing numbers of articles by ABA therapist-researchers insisting that "poorly-trained" therapists or lay-therapists cannot generate the reported benefits of ABA.

If ABA could be performed by the parents, its efficacy would not be such a question. However, with ABA therapists charging for their services and the reports that a certain minimal number of contact hours are required (cited between 16 and 40 hours a week), the efficacy of ABA is very much an issue.


In my experience, someone who is not well-versed in the techniques of ABA but is really good at getting into the child's world can have a much greater positive impact on that child's life than someone who simply has excellent training in ABA.

As I said, I have a "natural talent" in ABA. It just makes sense to me. It really is common sense good parenting, at its core. I've worked with more than twenty developmentally delayed children (most of them autistic) in the last six and a half years. All of them were between the ages of 2 and 13. When I started, I was an ABA purist. But there's something missing in "straight ABA", and nobody seems willing to consider that possibility. My approach now is fairly eclectic and based entirely on the child with whom I am working. First we build trust, because we can't have a functional relationship without trust. And then we start the "serious" teaching. I use the principles of ABA as regards reinforcement, and I find the assessment tools useful, but the curriculum? The specific teaching procedures? The behaviour management techniques? These I employ only as the situation warrants their use. Blanket statements such as "ignore behaviours to extinguish them" are patently useless. It's so vital to discover the real reason for a behaviour - we can't expect that every child screams "randomly" for attention any more than we can expect that every child likes chocolate.

In addition, the core tenets of behavioral analysis as put forth by experts in the field are hardly relevant to the discussion. As you pointed out, ABA has strayed far from the "true faith", so it is more relevant to parents to discuss how ABA is practiced in the community, which is a true "hodge-podge" of myth and mysticism.

ABA has been so twisted at this point from Skinner's original theories that there truly is no point in looking at the initial conception. Theories are theories, not practice, and we are talking about practice in this discussion.

Finally, you object to my equating "negative reinforcement" - inside inverted commas, to alert you to the non-standard use - with punishment. However, this was how some of the original work by Lovaas described yelling at children and striking them - "negative reinforcement" and "aversives" - nice euphamisms. Additionally, what may seem like negative reinforcement on one side of the table may seem a lot like punishment from the other side.

Well, to be fair... there are two types of negative reinforcement. One is similar to punishment, in that it involves the removal of something the child likes. The other is actually the removal of something the child dislikes. Similarly, there are two types of positive reinforcement. One is what we always think of in this sort of situation - the introduction of good stuff. The other is actually punishment, or the introduction of aversive stimuli. (And that's just the really simple explanation; there are more types of reinforcement, but this is the basic distinction that most ABA practitioners use.)

04 May, 2006 07:30  
Blogger Joseph said...

If ABA could be performed by the parents, its efficacy would not be such a question. However, with ABA therapists charging for their services and the reports that a certain minimal number of contact hours are required (cited between 16 and 40 hours a week), the efficacy of ABA is very much an issue.

I believe there's a recent replication of Lovaas that compares ABA done by parents vs. ABA done by professionals. It really finds no significant difference in outcome. Unfortunately, the study does not compare against a control group on placebo, as it should. So I'm really not sure what this tells us about the effectiveness of ABA.

Also, while ABA might be able to improve certain skills, I don't see how it might remove some of the characteristics of autism, such as obsessiveness, shyness or anxiety. In the case of anxiety, I could see how ABA might even make things worse.

04 May, 2006 10:18  
Anonymous Rolf Marvin Bøe Lindgren said...

Jannalou, (and for that matter, prometheus)

Well, to be fair... there are two types of negative reinforcement. One is similar to punishment, in that it involves the removal of something the child likes. The other is actually the removal of something the child dislikes. Similarly, there are two types of positive reinforcement. One is what we always think of in this sort of situation - the introduction of good stuff. The other is actually punishment, or the introduction of aversive stimuli. (And that's just the really simple explanation; there are more types of reinforcement, but this is the basic distinction that most ABA practitioners use.)

I don’t get this.

Something is called a reinforcer if it increases the strength or frequency of behaviior. Whether something is a reinforcer or not is established empirically. If it works by presentation, it’s a positive reinforcer, if it works by removal, it’s a negative reinforcer (the labels are not very pedagogical. they beg misunderstanding).

a typical example: if you do something for me, I’ll pay you for it at regular intervals each time you do it. If receiving money from me increases the quality of your deliverances, then money is a positive (presentation) reinforcer (behavior is strengthened by presentation). let’s assume now that I start paying you at regular intervals, and you are asked to do whatever it is I want you to do continuosuly. If you don’t, payment stops. Now money is a negative (removal) reinforcer (behavior is strengthened by removal). Negative reinforcement is often erroneusly labeled as punishment when it more properly should be labeled as coercion or escape.

Yelling can be a component of negative reinforcement. If I yell at my kid regularly for failing to tidy his room, and he tidies his room to avoid my yelling, then my yelling is a negative reinforcer for his tidying behavior (unfortunately, his tidying behavior reinforces my yelling).

most students study under negative reinforcement: they don’t study because studying is reinforcing. they study in order to avoid the conseuences of not studying. negative reinforcement is abundant and the most common behavioral modification tecnique, extremely popular in particular among those who don’t know behavior analysis. positive reinforcement is commonly more powerful and with less side effects, but often requires more imagination. negative reinforcers are usually easier to find than positive reinforcers.

there’s negative and positive reinforcement, then; and there’s negative and positive punishment. a positive punisher is a stimulus that, when presented, is followed by a decrease in strenght or frequency of behavior. a negative punisher is a stimulus that, when removed, is followed by a decrease in strenght or frequency of behavior.

so there’s negative and positive reinforcement, and negative and positive punishment. and those are the four ways that behavior can inter-react with the environment. then there’s reinforcement schedules - rates, as it were, of presenting or withdrawing reinforcers or punishers. different schedules provide different rates of learning or extinction. for example, freaquency of reinforcement is more efficient than strenght of reinforcement (as a general rule). companies would save money and increase productivity by adminestering bonuses more often (there are a few footnotes - but the basic idea is sound).

now, I can easily teach a goldfish to make eye contact. indeed, a friend of mine trained a cat to play possum and to fetch the paper. but teaching an autist to make eye contact is something else. if I teach an autist to make eye contact, that in itself will not make him or her less autistic. but improved eye contact will make the autist seem less avoiding to others, and more avaiable for social reinforcement. of course, teaching an autist to receive more social reinforcement with no training in how to handle it is unethical or at least not very nice.

40 hours of ABA a week!? talk about used car salesmen. the point behind ABA is that it is highly efficient.

OK, I get it. the ABA you talk about is not necessarily the ABA that I have come to know and love. but, you honor, I object anyway.

behavior analysis is a candle in the wind just now. and if ABA gets a bad name, even if it’s misapplied and misunderstood behavior analysis, it gives behavior analysis a bad name. I want there to be at least a critical mass of behavior analysts, enough to have journals and conferences and resarch.

04 May, 2006 15:23  
Blogger Jannalou said...

Something is called a reinforcer if it increases the strength or frequency of behaviior. Whether something is a reinforcer or not is established empirically. If it works by presentation, it’s a positive reinforcer, if it works by removal, it’s a negative reinforcer (the labels are not very pedagogical. they beg misunderstanding).

Oops. Sorry, you're right there. Regardless - I was more right than Prometheus was! *grin*

Basically (summarizing from my Intro to Psych text here):

Five consequences for behaviour:

1. Positive Reinforcers are stimuli that will increase a behaviour by being presented following said behaviour.

2. Negative Reinforcers are stimuli that will increase a behaviour by being removed following said behaviour.

3. Punishers are stimuli that will decrease a behaviour by being presented following said behaviour.

4. Response Cost is a form of punishment, but involves the removal of stimuli following an undesirable behaviour, in order to decrease said behaviour.

5. Extinction has to do with the elimination of a behaviour by removing reinforcement.

The first four items in the above list have to do with operant conditioning.

behavior analysis is a candle in the wind just now. and if ABA gets a bad name, even if it’s misapplied and misunderstood behavior analysis, it gives behavior analysis a bad name. I want there to be at least a critical mass of behavior analysts, enough to have journals and conferences and resarch.

There are plenty of journals and conferences; there needs to be more research. Make that more ethical research.

I am not against behaviour analysis. It makes sense. I'm definitely a behaviourist at heart. What I am against is the use of ABA to target autism, with the express purpose of making these people learn to "act normal". All "acting normal" does is cause extreme stress and anxiety. I know because I've been doing it all my life, to some extent.

04 May, 2006 17:08  
Anonymous Anonymous said...

The blog has moved on to another topic, but I thought that I should mention that there is newer research that that cited in the post that does achieve a replication comparable to that of the 1987 paper, and another that does compare EIBI to spending time wit a child.

You can access the complete articles and formulate your own opinion(s)

Intensive Behavioral Treatment for Children With Autism: Four-Year Outcome and Predictors; Glen O. Sallows and Tamlynn D. Graupner, Wisconsin Early Autism Project
AJMR; v110, no 6:417-438, Nov 2005
http://www.ctfeat.org/AmericanJournalMentalRetardationNov2005.pdf

A Comparison of Intensive Behavior Analytic and Eclectic Treatments for Young children with Autism; Howard, Sparkman, Cohen, Green and Stanislaw; Research in Developmental Disabilities, 26, 359-383 (2005)
http://www.ctfeat.org/ABAvEclectic.pdf

Regan

08 May, 2006 00:46  
Anonymous Marie said...

Realizing I could probably read your entire blog but also realizing that I don't have that much time on my hands, can you please quickly answer the following question:

What therapy do you choose for your child? What seems to be working for you? Obviously you're against ABA, so what DO you advocate?

23 May, 2006 07:44  
Anonymous Rolf Marvin Bøe Lindgren said...

I don’t think he’s against ABA as such. I think he’s against some of the claims that some ABA pracitinoers make.

Other commentors have submittet links to articles and information that suggests that ABA applied properly is highly effective, at least compared to anything else.

03 June, 2006 17:35  
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17 December, 2006 05:10  

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