In a Different Key: The Story of Autism (32 page)

Wolf and Risley pursued a “behavior analytical” approach. They started by observing how Dicky interacted with his mother and attendants at the state hospital. They witnessed his tantrums, which were nearly nonstop despite constant efforts by adults to calm him down. Obviously, this problem needed to be addressed before they could even start to work on the eyeglasses matter.

Inspired by two recent studies that had nothing to do with autism, they pursued a program of mild punishment and “extinction” designed to eliminate Dicky’s tantrums. In the first of those studies, researchers at the University of Washington had succeeded in changing the behavior of several difficult-to-handle nursery-school children—in ways that could be enumerated and graphed—by instructing their teachers to ignore them completely whenever they displayed certain “undesirable” behaviors (which included excessive crying, isolated play, and uncontrolled self-scratching). As a result of this withdrawal of teacher attention, the undesirable behaviors quickly underwent “extinction” and were rapidly eliminated.

Conversely, when the children switched to more appropriate behaviors—cooperative play, for example—they immediately began to receive attention again from their teachers. This attention proved to be reinforcing, and these more appropriate behaviors quickly increased in frequency. “Attention” did not just mean the teachers praised the children. It was subtler than that. Moving closer to them, smiling at them,
and offering to help them all counted as attention. What today is seen as conventional parenting wisdom was in fact a breakthrough discovery made at the UW labs in 1962. Previously, the powerful reinforcing effect on a child of attention from an adult had not been appreciated.

Knowing this, the team watching Dicky quickly formed the hypothesis that the attention he attracted during tantrums might be reinforcing them, even causing them to happen more often. Indeed, the hospital staff had orders to try to soothe Dicky whenever he became upset. His mother, understandably, had the same impulse. But what most people would call maternal instinct—or love—looked to the behavior analysts like the source of the problem. Dicky’s mother was rewarding him for blowing up, though that was never her intention.

The other study Wolf and Risley drew upon had pigeons as its subjects, and its most interesting discovery was something of an accident. The researcher in that study did not want his pigeons pecking at the food-releasing levers in the intervals between experiments. He found that, if he shut off the lights in the space the pigeons occupied, putting them in darkness, they stopped the unwanted pecking behavior. He began using this method regularly, calling it a “time out.” It was the same “time out” that was destined to become a widely adopted disciplinary tool used by parents and teachers across the United States—few of whom realized that the method had started in a behaviorist’s lab, and then traveled, by word of mouth, probably by way of teachers’ courses taught by psychologists with some behavioral training. In 1963, however, it was new, and only pigeon-tested. When Wolf and Risley decided to try using it as a “mild punishment” to discourage Dicky’s tantrums, it was probably the first scientifically controlled use of the technique with a person.

As instructed by the behavior analysts, the hospital staff and Dicky’s parents began to respond in a new way when Dicky began to act up. The adults nearby remained calm and paid him not the slightest attention, other than taking him immediately by the hand and, in a perfunctory way, leading him to a designated “time-out” room. Without fuss, without talk, without hugs, the door was closed, and Dicky was left alone in the room for a period of ten minutes.

The results were dramatic. Denied adult attention, the boy became
progressively better at calming himself down during each successive time out. Over weeks, this required less and less time, and his tantrums became less and less violent. After two and a half months, Dicky was no longer scratching or slapping his face at all when he blew up. Eventually, his outbursts dwindled to so few in number that they ceased to be the defining factor in his interaction with others.

Now the two psychologists could attack the main challenge: getting eyeglasses on a three-year-old who hated anybody, or anything, touching his head. For this, Wolf and Risley turned to a classic behaviorist technique known as
shaping
. They began by getting Dicky used to the idea of simply being near eyeglasses. They placed several pairs of frames around the room, without lenses in them, and gave him a reward whenever he moved in the direction of any of them—even when the movement was clearly random. In time, this brought him closer and closer to the frames, to the point where he was reaching out and touching them. Whenever this happened, he was rewarded again—and then again when he brought them near his face. The researchers tried to keep him hungry, so that the reinforcers they were using—bits of candy and fruit at one point, breakfast in small bites at another—would motivate him. But after several days, it appeared that these reinforcers were losing their appeal. Progress slowed.

Then, late one morning, after Dicky was deliberately denied breakfast, Wolf and Risley showed up with ice cream. That changed everything. Dicky apparently loved ice cream, because soon he was letting the glasses be placed on his head and allowing them to be set more and more snugly onto the bridge of his nose, and even over and around his ears. He had a little trouble with the last part, tending to wrap them under his ears, but that was resolved over several sessions, with yet more ice cream.

Wolf and Risley had left the lenses out of the frames on purpose, concerned that it might be too intense an experience for Dicky suddenly to see things in sharp focus. But then lenses were added to the frames, and the prescription was ramped up, from weaker to stronger, all in separate sessions, and all of it shaped by spoonfuls of positive reinforcement for every right move. It took months, but in the end,
before he went home, Dicky was wearing his glasses twelve hours a day. This small achievement was, in fact, a stunning outcome.

Over the next several months, Wolf and Risley continued working with Dicky, trying to teach him to talk. Working with pictures of objects, along with plenty of rewards, they gradually shaped his echolalic speech into something more obviously practical. At the beginning, his speech was no more than rote recitation—words for ice cream. But over more months and then years, with his parents joining in as teachers, Dicky’s verbal skills improved to the point where he was able to ask for the things he wanted.

Having that amount of language—and being able to see—changed Dicky’s life. Eventually, he was able to go to school, and then, as a young adult, to get a part-time job as a janitor and to live on his own in an apartment, with occasional supervision. The team from the University of Washington hadn’t cured Dicky’s autism, but they had helped him find a place in the world.

—

W
OLF AND
R
ISLEY
got through to Dicky, in the end, with ice cream. A positive reinforcer. A reward. Actually, a frozen dessert also made a fleeting appearance in that May 1965
LIFE
spread about Lovaas’s project at UCLA. The text specified that the program relied overwhelmingly on positive reinforcers, especially food—including sherbet—and that in Lovaas’s lab, the kids were shown “persistent and loving attention.” A few pictures even showed kids being hugged, validating the last word in the article’s title: “Screams, Slaps & Love.”

But the article also revealed that the kids were kept hungry to keep them working hard for that food. And the overall impact of the pictures probably left most readers thinking that, at the heart of Lovaas’s program, the children were being punished for having a condition that was described in relentlessly bleak terms.

Autism,
LIFE
explained, was a “special form of schizophrenia,” which resulted in “utterly withdrawn children whose minds are sealed against all human contact and whose uncontrolled madness had turned their homes into hells.” Living with autism was “a nightmare” and an
“appalling gallery of madness.” Certainly, it sounded worse even than the misery depicted in Lovaas’s lab.

The lead-off photo shows Billy, a three-year-old who could not speak, with tears rolling down his face, as a man in a necktie, his face twisted in anger, bellows at him. The man pictured was not Lovaas but Bernard Perloff, a fellow researcher. It is Perloff’s open palm that comes up against the left side of Billy’s head, either grabbing it or smacking it. Either way, he appears to be furiously berating the boy. The text explained why: during a speech lesson, Billy’s attention had wandered, and Perloff hit him to get him focused again. In the third picture in the sequence, the two of them are so close together, they’re nearly touching noses, and Billy, though his lower lip looks like it’s trembling, is looking Perloff straight in the eye.

The girl seen getting shocked with electricity is identified as Pamela, a nine-year-old. She, too, had just become distracted from the task at hand—a reading lesson with Lovaas.

By this time, Lovaas was in his second or third year of experiments using ABA with autistic children. But he was not trying to discover the nature of autism. As
LIFE
put it, “The team conducting the experiment at UCLA is not interested in causes.” Instead, “by forcing a change in the child’s outward behavior,” according to the article, Lovaas hoped to force an inward change as well. He was trying to teach them to make eye contact, to form and use words, to read, to hug.

The work,
LIFE
made clear, was worth the time and the suffering. ABA worked.
LIFE
’s readers were told that Billy, for example, had been taught to say his own name, remarkable for a child who before had only grunted and squealed. Rewarding Billy with a steady stream of hugs and food, Lovaas had spent days teaching him to bring his lips together as if to produce the
b
sound. That achieved, the next phase was to prompt and then reward Billy for bringing his vocal cords into it—to make the silent
b
into a full-throated “Buh.” If Billy’s attention strayed for too long, Lovaas would slap his face. And on it went, through the rest of the sounds that made up his name until he could say “Billy” on his own—a triumph in a single word.

Over the next twenty years, Lovaas would continue to refine and experiment with his method, but a key pillar of it was on display in
the
LIFE
layout: the breaking down of any task into small, teachable, learnable performances of behavior. The
LIFE
story left readers on an upbeat note, thanks to a sequence of pictures Grant took of one of the mothers who had come by the lab and was watching her son from inside a darkened room, behind a one-way mirror. On that day, her son was being taught to embrace one of the other boys, in something that at least resembled a real hug. In the dimness, she is seen biting her thumbnails as the lesson unfolds. Then the hug happens. Delighted, she throws back her head and laughs, clapping her hands at the same time. She is “overjoyed at what she sees,” the caption says. In that brief instant, at least, what Lovaas was doing seemed well worth whatever tears were being shed along the way. As
LIFE
summed up the work: “Lovaas hopes he has found a way to help any child with a broken mind more quickly and simply than with methods now used.”

—

T
HE MOTHER WHO
laughed and clapped her hands was behind a one-way mirror, invisible to Lovaas. In fact, though, he needed parents like her. Their support for what he was doing was his best protection against the criticism that the methods he was developing were extreme, cruel, or unethical.

It could only have been heartening to Lovaas, therefore, when, within days of the
LIFE
article’s appearance, parents from all over the country called and left messages via the UCLA switchboard, or sat down and wrote urgent, beseeching letters, seeking a spot in his program for their own child. Lovaas was not equipped to handle such a sudden volume of interest, and so he passed on all the letters and names to a recent acquaintance of his named Bernie Rimland. They had met several months earlier, before the
LIFE
story, in late 1964.

Rimland had yet to become a major figure in autism, since his historic book taking down the refrigerator mother had only just come out. As ever, he was continuing to track down any sort of new research that touched on autism, scarce as that was. That autumn, having heard informally about Lovaas’s early punishment studies, he showed up in Lovaas’s office in UCLA’s Franz Hall, and introduced himself. They spent the rest of the day together, with Lovaas showing Rimland how
he was teaching nonverbal children to use words. Rimland was astounded and told Lovaas as much, then he invited Lovaas to a dinner he was attending that evening.

When Rimland told Lovaas that they would be joined by a number of couples, all parents of children with autism, Lovaas immediately made his excuses. As he later confessed, he could not stand being around the parents of the kids brought to his lab. It was not that he blamed mothers for causing their autism; yes, he had at one point espoused that belief, but had long since rejected it on his own. Yet he could not help finding the parents he met to be depressingly glum, withdrawn, or vaguely hostile. As a rule, he tried to avoid them. So he declined Rimland’s invitation.

Rimland, however, persisted, and turned on the charm, telling Lovaas that the parents would be dazzled by hearing what he was doing with kids like theirs. Finally, Lovaas gave in.

That night marked the turning point in Lovaas’s relationship with the parents of the children he studied. The group he met, over red wine and plates of pasta, was not at all what he had expected. Away from the laboratory and their children, they impressed him as relaxed, charming, and engaging. They asked good questions. They laughed at one another’s jokes. The next morning, when Lovaas returned to his lab, a new thought took shape in his mind:
These people would make excellent allies
.