Autism is a serious psychological disorder with onset in early childhood. Autistic children show minimal emotional attachment, absent or abnormal speech, retarded IQ, ritualistic behaviors, aggression, and self-injury. The prognosis is very poor, and medical therapies have not proven effective. This article reports the results of behavior modification treatment for two groups of similarly constituted, young autistic children. Follow-up data from an intensive, long-term experimental treatment group (n = 19) showed that 47% achieved normal intellectual and educational functioning, with normal-range IQ scores and successful first grade performance in public schools. Another 40% were mildly retarded and assigned to special classes for the language delayed, and only 10% were profoundly retarded and assigned to classes for the autistic/retarded. In contrast, only 2% of the controlgroup children (n = 40) achieved normal educational and intellectual functioning; 45% were mildly retarded and placed in language-delayed classes, and 53% were severely retarded and placed in autistic/retarded classes. Kanner (1943) defined autistic children as children who exhibit (a) serious failure to develop relationships with other people before 30 months of age, (b) problems in development of normal language, (c) ritualistic and obsessional behaviors ("insistence on sameness"), and (d) potential for normal intelligence. A more complete behavioral definition has been provided elsewhere (Lovaas, Koegel, Simmons, & Long, 1973). The etiology of autism is not known, and the outcome is very poor. In a follow-up study on young autistic children, Rutter (1970) reported that only 1.5% of his group (n = 63) had achieved normat functioning. About 35% showed fair or good adjustment, usually required some degree of supervision, experienced some diffaculties with people, had no personal friends, and showed minor oddities of behavior. The majority (more than 60%) remained severely handicapped and were living in hospitals for mentally retarded or psychotic individuals or in other protective settings. Initial IQ scores appeared stable over time. Other studies (Brown, 1969;

We have treated 20 autistic children with behavior therapy. At intake, most of the children were severely disturbed, having symptoms indicating an extremely poor prognosis. The children were treated in separate groups, and some were treated more than once, allowing for within-and between-subject replications of treatment effects. We have employed reliable measures of generalization across situations and behaviors as well as across time (follow-up). The findings can be summarized as follows: (1) Inappropriate behaviors (self-stimulation and echolalia) decreased during treatment, and appropriate behaviors (appropriate speech, appropriate play, and social non-verbal behaviors) increased.(2) Spontaneous social interactions and the spontaneous use of language occurred about eight months into treatment for some of the children. (3) IQs and social quotients reflected improvement during treatment. (4) There were no exceptions to the improvement, however, some of the children improved more than others. (5) Follow-up measures recorded 1 to 4 yr after treatment showed that large differences between groups of children depended upon the post-treatment environment (those groups whose parents were trained to carry out behavior therapy continued to improve, while children who were institutionalized regressed). (6) A brief reinstatement of behavior therapy could temporarily re-establish some of the original therapeutic gains made by the children who were subsequently institutionalized.The first succinct attempt to understand the behavior of autistic children within a behavioristic framework was carried out by Ferster (1961) Ferster presented a very convincing argument of how it was that, based on a general deficiency in acquired reinforcers, one might expect the very impoverished behavioral development one sees in autistic children. The 'We express our thanks to the parents who entrusted their children to us, and for the help and encouragement they have given.

Infantile autism is a severe form of psychopathology characterized by profound behavioral deficits. This article reviews a series of investigations which suggest that autistic children show "stimulus overselectivity," a response to only a limited number of cues in their environment, and discusses how such overselectivity may relate to several of the behavioral deficits in autism. These include failure to develop normal language or social behavior, failure to generalize newly acquired behavior to new stimulus situations, failure to learn from traditional teaching techniques that use prompts, and a general difficulty in learning new behaviors. This discussion is followed by the presentation of several studies that suggest possible remedial procedures. Finally, the concept of stimulus overselectivity is related to the literature on other theories of attentional or response deficits in adult schizophrenia, mental retardation, learning disabilities, and autism.Infantile autism, first described by Kanner (1943), is a severe form of psychopathology in children that is characterized by extreme social and emotional detachment. Such children typically do not seek or readily accept affection and do not play with peers. They engage in great amounts of stereotyped, ritualistic, and repetitive motor behaviors and are generally unresponsive to their physical environment. They are inconsistent in their response to sensory input, they typically do not show a startle reflex, and their parents have suspected them to be blind or deaf. Language development is either absent or

The study attempted to isolate some of the environmental conditions that controlled the self-destructive behavior of three severely retarded and psychotic children. In the extinction study subjects were placed in a room where they were allowed to hurt themselves, isolated from interpersonal contact. They eventually ceased to hurt themselves in that situation, the rate of self-destruction falling gradually over successive days. In the punishment study, subjects were administered painful electric shock contingent on the self-destructive behavior.(1) The self-destructive behavior was immediately suppressed. (2) The behavior recurred when shock was removed. (3) The suppression was selective, both across physical locales and interpersonal situations, as a function of the presence of shock. (4) Generalized effects on other, non-shock behaviors, appeared in a clinically desirable direction. Finally, a study was reported where self-destructive behavior increased when certain social attentions were given contingent upon that behavior.

Three groups of children (autistic, retarded, and normal) were reinforced for responding to a complex stimulus involving the simultaneous presentation of auditory, visual, and tactile cues. Once this discrimination was established, elements of the complex were presented separately to assess which aspects of the complex stimulus had acquired control over the child's behavior. We found that: («) the autistics responded primarily to only one of the cues; the normals responded uniformly to all three cues; and the retardates functioned between these two extremes, (i) Conditions could be arranged such that a cue which had remained nonfunctional when presented in association with other cues could be established as functional when trained separately. The data failed to support notions that any one sense modality is impaired in autistic children. Rather, when presented with a stimulus complex, their attention was overselective. The findings were related to the literature on selective attention. Since much learning involves contiguous or near-contiguous pairing of two or more stimuli, failure to respond to one of the stimuli might be an important factor in the development of autism.