Wisconsin Early Autism Project Leads The Way In Aba Treatment

Wisconsin autism activists felt years of effort pay offfunding.
last year when Gov. Jim Doyle issued an emergency“I had to have enough money to run 40 hours a
rule requiring insurance coverage of autism spectrumweek,” he said.
disorders.He sent a funding request to the state Department of
The emergency rule, which went into effect Nov. 1,Health and Families Services (now known as the
mandates autism coverage for health insuranceDepartment of Health Services).
policies issued by an insurer. The rule does not apply to“They rejected it on the grounds that this treatment
employers with self-funded health plans. The rule lastswas experimental,” Sallows said. “I called Lovaas
for a year while the Office of the Commissioner ofand he gave me names of people all across the
Insurance comes up with a permanent rule.country to write letters. One of them, Bernard Rimland,
The law requires a minimum of $50,000 a year forhe’s sort of famous being one of the founders of
intensive evidence-based treatment, and $25,000the Autism Society of America, he wrote this funny
annually for non-intensive services.letter, two sentences, ‘You asked if behavior
As autism diagnoses grew in the 1990s and firsttreatment for autism is experimental. Absolutely
decade of this century, so did the variety ofnot.’”
treatments, everything from diet change toThe letters helped win a hearing for the program.
psycho-educational interventions. But“We won the hearing,” he said. “After that
“evidence-based treatment” at the momentmy wife (Tamlynn Graupner, WEAP co-founder, CEO
refers to Applied Behavioral Analysis, an intensiveand clinician) and I met with people at DHFS. There
intervention method developed by clinical psychologistwere no codes for this. There was no protocol for
Dr. O. Ivar Lovaas.what should and should not be funded. We hammered
Lovaas, his staff and students trained in his methodit all out. That took until March of ’95 to get that all
worked one-on-one with autistic children aged two todone.”
four. The work – 40 hours a week of structuredWEAP opened an office in Madison.
training – was conducted in the children’s homes,“But we were getting referrals from all over the
with parents participating so they could continue thestate,” he said. “We were the only ones certified
behavioral training on their own.to do it in Wisconsin.”
After studying three groups of children through age 7Today WEAP operates the original Madison clinic as
– the experimental group receiving the Lovaaswell as offices in Milwaukee, Eau Claire and Green
Technique, a control group that received someBay.
behavioral training and other treatments, and a thirdAnd in 2005 Sallows kept his promise to Lovaas when
group that received no behavioral treatment –he and his wife published a paper replicating his
Lovaas published his results in 1987 and reported thatfindings.
47% of the children in the group that received intensive“The thing that’s really important about our
behavioral therapy were functioning normally.study, we’re really the first ones in the world to
His results caused a stir in the then relatively smallactually replicate with a similar population,” Sallows
autism community, especially when other studies weresaid. “Actually, our population was somewhat lower
unable to replicate Lovaas’ results.functioning than his. His average IQ for kids beginning
“People were starting to say about Lovaas’treatment was 60 and ours was 51. Lovaas got 47%
treatment, ‘It can’t be true. He’s faking hisof his kids to reach best outcome; we got 48%. You
data.’ That caused a war in literature betweencouldn’t replicate it much closer than that.”
camps for years,” said Dr. Glen Sallows, presidentSallows said the WEAP study put an end to doubts
and co-founder of the Wisconsin Early Autism Project,about ABA, at least among serious researchers in the
a program and clinic with treatment based onfield.
Lovaas’ work.“Cathy Lord, who is very famous in autism –
“Lovaas’ study came out in ’87 and heshe’s the main author of the two most famous
updated it in ’93, but no was ever been able todiagnostic tools, ADIR (Autism Diagnostic
replicate it,” Sallows said. “There were severalInterview-Revised ) and ADOS (Autism Diagnostic
attempts to replicate it. In my mind, there were goodObservation Schedule) – before our study came
reasons why those didn’t work as well. Theyout, she was saying, ‘OK, we agree that
didn’t have enough hours. By and large they wereLovaas’ method works. But we don’t know
at universities and didn’t have access to muchwhy. It was a fluke.’ Then our study came out and
money so they didn’t have the hours. Theythat really put a stop to all that talk. Geraldine Dawson
didn’t do it long enough to bring about the changes.at Washington State in Seattle has published a couple
And I don’t think people understood how muchof really big studies. She’s into brain imaging. She
supervision and training you have to give your linewanted a copy of our paper and quoted it. We’re
staff.”one of only a couple of autism programs across the
Sallows, originally from Los Angeles, had Lovaas as ancountry she put in her reference list. Everybody now
instructor when he was an undergraduate at UCLA inkind of agrees this treatment does work.”
the 1960s. He went on to the behavior-orientedStill, Sallows knows ABA treatment is competing with
graduate school at the University of Oregon. Upona host of other treatments.
graduation, Sallows’ first job was as a psychologist“There are things on the internet that I don’t
for a children’s mental health clinic in New Jersey. Inthink are supported by research. We pretty much stick
1979 he joined the staff at the Mendota Mental Healthto what’s been researched by us or by somebody
Institute in Madison, and in 1981 led the autism unit there.else,” he said. “So many parents are trying
Sallows had read about Lovaas’ treatmentgluten- and casein-free diets and supplements. There
methods. Following those methods, Sallows treated anare more and more doctors that follow the DAN
autistic boy who responded.protocol (Defeat Autism Now!, a project of the Autism
“He did quite well,” Sallows said. “I decidedResearch Institute), but there’s no data to support
that was pretty fun. I called up Lovaas and said Ithat. For the most part, I feel it’s kind of harmless.
wanted to be trained in his way of doing it. He said,But chelation (a method to remove heavy metals from
‘OK, I’ll train you if you run a replication site forthe body) is not harmless. There’s only been one
me.’”death and most parents don’t believe it will happen
Sallows studied with Lovaas in 1994-95, and then leftto their child. But, again, there’s no data. The
Mendota to start the Wisconsin Early Autism Project.problem I have sometimes if a kid is on a bunch of
“I started hiring staff and it grew from there,” hesupplements or on chelation and he gets upset, I tell the
said. “I m just a dyed-in-the-wool clinician. You wantparents, I don’t know what I’m seeing now.
to help everybody. At that time there was no funding.I’ve given up trying to argue them out of using
There were no providers living in Wisconsin. Therebiomedical stuff. It’s all over. Everybody’s talking
was a provider in Chicago who was working withabout it, but it does very little. It might do a little bit, but
people in Milwaukee, but they were charging someit’s certainly not the cure for autism.”
high prices.”If parents want to research treatments online, Sallows
Being a startup operation with a promise to keepsuggests they stick with proven data.
about replicating Lovaas’ study, WEAP needed