Background to my interest in teaching children with autism

PSYCHOTHERAPY BEYOND THE FRINGE, continued
The Pain Analog Measure (PAM) used a borrowed audiometer – a device which allows a tone of controlled pitch and volume to be fed to either ear or to both. In this case, it was fed to both ears through a headset. Sadie set the pitch and volume for herself, although she couldn’t see the calibrations around the control knobs because the dials were covered. She was asked to indicate, by turning the knobs, both the quality and the quantity of any pain that she might be feeling in her body, but she was never asked to say where the pain, if any, was. She was asked first to turn the pitch knob to try to match or represent the quality of any pain she was experiencing, setting a relatively high pitch if the pain was sharp, or a relatively low pitch if the pain felt dull. She was then asked to set the volume knob to represent the quantity or intensity of the pain, with high volume to match or represent strong or intense pain, and low volume to match or represent rather low intensity pain. Felicity hoped that Sadie would be able to ‘communicate’ any pain she was feeling in this indirect way, even if she could not do so in words. The measures of pitch and volume were recorded as the pain ‘scores’ at each testing session.
Sure enough, the pain measures rose and fell, with the rises occurring in advance of a tantrum, and the drops occurring after a tantrum. But the pain measures often started to increase hours before a tantrum, long before the anxiety measures were increasing. And the pain measures fell immediately after a tantrum, and then fluctuated for a while before settling down. This pattern would be consistent with the idea that the accumulation of pain was triggering the tantrums.
Had Felicity’s hypothesis been proved? It had not. All that was known was that Sadie felt increases in anxiety and pain which were associated with the approach of a tantrum, and reductions after the tantrum was over. Felicity knew that the test scores alone would not confirm his idea. The real question of importance was what might happen if the pain was modified? This brings us to the anxiety-relief conditioning and the differences between the methods used in the two sets of conditioning sessions.
The conditioning using the right hand and the signal: ‘Right’ should, theoretically, have worked as anxiety-relief conditioning usually works – to reduce her anxiety. And the changes in the anxiety measures suggested that it worked as it ‘should’. The electrical stimulation of the mutilated left hand using the signal: ‘Left’, ‘should’ have increased the pain in her presumably already hurting left hand, and ‘should’ have reduced the pain following utterance of the new (different, ‘Left’) signal. Thus, the second anxiety-relief conditioning procedure ‘should’ have produced a conditioned reduction of both anxiety and pain. If true, the measures of both anxiety and pain should have been reduced during and following the second (and not the first) anxiety-relief conditioning procedure. What in fact happened?

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