Autism Isn't Only For Children
Published May 24, 2009 @ 03:34PM PT

I've been writing a lot over the past few months of the struggles (some rather monumental) of my son, who's now an adolescent. I know there are books and guides and more out there, but it often feels like we're completely reinventing the wheel and throwing up our hands to say "now what do we do?" at any and every moment. So many books about autism by parents focus on diagnosis of a young child, figuring out treatments and therapies and and early intervention and finding a preschool or school---as writer Karl Taro Greenfeld points out in an op-ed in today's New York Times:
For purposes of fund-raising and awareness-raising, autism has been portrayed as a childhood disease. The federal Department of Health and Human Services has characterized it as a “disorder of childhood.” There are practical reasons for this: early intervention has been shown to be the most effective therapy. The trend in autism treatment has been to steadily lower the age at which intensive intervention commences — as early as five months, according to some experts. Yet autism is not a degenerative condition; the vast majority of those 1 in 150 children who are afflicted will survive to adulthood.
Greenfeld's recently published book, Boy Alone: A Brother's Memoir, is about his life growing up with his now 42-year-old brother, Noah. The focus on children has also, Greenfeld writes, influenced research and treatment and he notes how Noah's life has been a "grim study" in how scarce resources for autistic adults have been, and are: "We have long since given up any hope that he might continue in adulthood the behavioral therapies that are now considered standard for autistics; unless the family is willing to pay the bulk of the cost, there is very little out there for men and women like Noah."
This is why we've got to urge Congress to pass the Autism Treatment Acceleration Act, which contains specific provisions for creating planning and demonstration grants for services for adults. There's much about Noah Greenfeld that reminds me of my own son. He's got pre-vocational skills, his teacher tells us, but Charlie also still struggles with tremendous behavioral challenges that could make employment in a public setting impossible. He may be 12 and an adolescent, but we've started to think most of all about his life as an adult, as if he is already 42 years old like Noah Greenfeld.
And Charlie's not the only one who'll have many needs, needs to be addressed now. For Noah Greenfeld and many others today, and many more individuals tomorrow.
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Comments (13)
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Indeed. Focus on adult issues -- rights *and* services -- is sorely lacking among the big autism organizations, or, at best, way behind where it should be, and that has to change.
Posted by Phil Schwarz on 05/24/2009 @ 05:46PM PT
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Charlie's had ten years of an excellent education---and that means he needs many more years of equally solid support now and in the years to come.
Posted by Kristina Chew on 05/24/2009 @ 05:58PM PT
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@Kristina.You make an excellent point about getting an excellent education due to solid support. Before they passed IDEA in the 1970's parents faced the same situation you are facing at age 21. No safety net at all.
Before IDEA there really were no support services from birth to ?? except institutionalization. Kids stayed at home. Some non-profits might do speech. No network of support organizations. Parents were left on their own. No safety net of supports and services.
"Before IDEA, many children like Lee were denied access to education and opportunities to learn. For example, in 1970, U.S. schools educated only one in five children with disabilities, and many states had laws excluding certain students, including children who were deaf, blind, emotionally disturbed or mentally retarded, from its schools.
Thirty Years of Progress in Educating Children with Disabilities Through IDEA
http://www.ed.gov/policy/speced/leg/idea/history30.html
By requiring schools to educate our kids the IDEA law now provides services until age 21 (varies by state). Also provisions in the law(transitional services) require the school to develop a plan/implement services the child will need as an adult before age 21.
What is the Lanterman Development Disabilities Services Act?
http://www.ggrc.org/rr_lanterman_act.htm
The Lanterman Developmental Disabilities Services Act (Lanterman Act) is that part of California law that sets out the rights and responsibilities of persons with developmental disabilities, and creates the agencies, including regional centers, responsible for planning and coordinating services and supports for persons with developmental disabilities and their families.
Section 4501 of the Lanterman Act states: "The State of California accepts a responsibility for persons with developmental disabilities and an obligation to them which it must discharge. Affecting hundreds of thousands of children and adults directly, and having an important impact on the lives of their families, neighbors and whole communities, developmental disabilities present social, medical, economic and legal problems of extreme importance."
Section 4620: "In order for the state to carry out many of its responsibilities as established in this division, the state shall contract with appropriate agencies to provide fixed points of contact in the community for persons with developmental disabilities and their families, to the end that such persons may have access to the facilities and services best suited to them throughout their lifetime. It is the intent of this division that the network of regional centers for persons with developmental disabilities and their families be accessible to every family in need of regional center services.
http://en.wikipedia.org/wiki/Lanterman_Developmental_Disabilities_Act
My brother got put into the system for Medicare, Vocational Rehab etc. after I couldn't take care of him and my autistic child at the same time. The hospital social worker had to put him in the system because they couldn't discharge him homeless. The hospital social worker said if the school didn't put you in the system then the only other way of getting services is by being homeless.
So what makes IDEA in the 1970's possible in the first place? The cries of parents saying that they pay taxes too. The outrage from these parents that it was unfair that their child wasn't allowed an education.
I believe that if all the autistic groups could work together there could be a big outrage about adult services/supports. Otherwise we are splintered and disorganized. No one understands what we are about or what we want.
There is conflict without agreement. Our children need help now.
Posted by L I on 05/25/2009 @ 04:14PM PT
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I think we really forget that there was a time before IDEA here in the US --- seems unimaginable, but sometimes I think we need to think of what things would be like without IDEA and its protections, so we can best focus on what we need to work towards.
Posted by Kristina Chew on 05/25/2009 @ 04:26PM PT
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@Kristina."so we can best focus on what we need to work towards".
Right on!!
Posted by L I on 05/25/2009 @ 06:46PM PT
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Definitely adult services (and understanding that autistic children grow up to be autistic adults who may need ongoing support) is important. Even for those of us who have managed to get jobs, etc., as adults, things are still very precarious. I have had the same job (which I got in part because my parents helped me set it up when I was in school, and which I did not even have to interview for because I got to do the job-tryout thing via internship) since 2002. And with the economy being what it is especially who knows what will happen.
And also I think right now for many of us on the spectrum, when things are going well it is because there are so many little things all precisely in place - like we can go from "okay" to "crisis" very easily due to support systems just not being there for us, etc.
In any case I think that one of the most important things is to not warehouse people, and to fight against the idea that some people "have" to be institutionalized (and also the idea that an institution is a type of building and not a type of power structure). There is absolutely no reason ANYONE should be put into a living situation where they are essentially treated like a prisoner and it is presumed that cognitive and other disabilities mean they cannot actually be taught about agency and self-respect.
Posted by Anne Corwin on 05/24/2009 @ 11:20PM PT
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@Anne.
And also I think right now for many of us on the spectrum, when things are going well it is because there are so many little things all precisely in place - like we can go from "okay" to "crisis" very easily due to support systems just not being there for us, etc.
You make an excellent point. Support systems in place when crisis happens.
Posted by L I on 05/25/2009 @ 01:00PM PT
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I'm a bit concerned myself by what seems to be a focus on behaviour modification in the accelerated autism treatment bill. It is known that around 60% of autistic children do NOT benefit and some clearly suffer from being exposed to intensive interference in how they behave. Perhaps I'm wrong, and the Bill makes provision for *flexible* early support, rather than IBI/ABA as the sole or main approved and hence funded options? The motives of some of the people pushing this Bill may be more commercial than principled?
Posted by dinah murray on 05/25/2009 @ 12:19AM PT
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@Dinah. "The motives of some of the people pushing this Bill may be more commercial than principled?"
Since legislation is influenced at times by special interest groups I think you say an important point.
There should be some type of guidelines so that children are not harmed. It should be clear to everyone when behavior modication should be used or not used in treatment programs and in the classroom.
Usually positive behavior intervention plans in the classroom use a check list format and there are several people signing off at the end of the checklist. There is ongoing monitoring and evaluation if done properly. Parents are involved in each step of the process.
Posted by L I on 05/25/2009 @ 02:50PM PT
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I have advocated locally for autism services at all age levels with a current focus on adult residential care. I concur fully with the need for more attention on autistic adult issues.
Having said that I am amazed that, instead of focusing on the adult care issues, dinah murray simply uses the topic as a springboard to bash ABA, the ONLY evidence backed effective intervention for autism to date. And her facts are wrong.
If Ms Murray wants to help autistic adults let go of the anti-ABA obsession.
Posted by Harold L Doherty on 05/25/2009 @ 03:52AM PT
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Mr Doherty expresses surprise that I would make a comment not applying to adults in the context of these comments, and suggests I am ABA obsessed.
If he will take a look at any of the three websites I've been associated with since the late 1990s he will find evidence of well over a decade of campaigning re issues which impact on autistic adults such as medication and access to information technology. (www.autismandcomputing.org.uk ; www.APANA.org.uk, now at www.neurodiversityinternational.org.uk/APANA/ ; www.autreach.i)
He will not, I believe, find any mention of ABA/IBI on any of those sites. It is true, however that I was the researcher employed on this:Jordan R., Jones G., and Murray D. 1998 Educational Interventions for Children with Autism. DfEE Research Report 77. Norwich : HMSO, which concluded that ABA should not be seen as the "gold standard".
It is perhaps not me who has the ABA obsession?
Posted by dinah murray on 05/26/2009 @ 10:35PM PT
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"It is perhaps not me who has the ABA obsession?"
Indeed, to suggest that you are 'obsessively anti-ABA' is to show ignorance of who you are in the autism world and what you have done for people with autism. Your work - unlike Harolds - is easily found through google.
Aside from your comment being about behaviour modification programmes in general, you were also talking about having other options on the table (such as assistive devices, assistive communication devices, environmental adaptations SIT etc).
To accuse you of ignoring the issues because you appear to wish to address them all is just another silly claim from Harold to go on top of the pile of silly Haroldisms.
Posted by Dedj C on 05/28/2009 @ 09:37AM PT
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I think there should be more autistic books written on parenting an autistic child. These books should not focus on treatments and causes. Rather on family and helping your child with her/him challenges. So many parents have figured out great things from books, from the child, and from themselves and other people. We are beginning to see books that focus on the early years, we still need books on elementary, junior high, high school and adulthood as some of the blog parents have indicated.
Posted by L I on 05/25/2009 @ 02:43PM PT
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