Nevada judge creates ABA program to keep teens out of jail

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ASPartOfMe
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12 Feb 2024, 9:49 am

Youth with autism are more likely to be arrested. A Nevada judge wants to remedy that

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Melody O'Connor is grateful her teenage daughter Angeleena O'Connor was arrested in the winter of 2022.

"Isn't that a horrible thing to say?" Melody said.

It wasn't the first time Angeleena had the police called on her. The first time was more than four years earlier – when she was 12.

Angeleena is now 16 and the police have been called to her house more than 40 times over the past four years, including once for a violent incident in which Angeleena grabbed a steak knife and held it to her mother's face, Melody said.

Angeleena was adopted by Melody as an infant.

"Angeleena is actually my second cousin," Meloday said in early January, speaking from the comfort of her North Las Vegas home over Zoom.

She initially took Angeleena in when she was just 10 months old and then again, permanently, once Angeleena was 2 years old. When she was a toddler, Melody says Angeleena's violent episodes were manageable.

I could just grab her and restrain her or throw her over my shoulder, carry her out of a store, stuff like that. But now that she's my size, and she's older, she's extremely strong," Melody said.

There's also been an uptick in her violent behavior, including property destruction, threats to their pet dog, Daisy, and suicidal ideations.

"The thing about Angeleena is when she has these episodes, she glazes over, she becomes a different person. She is like Jekyll and Hyde when she flips," Melody said.

Angeleena has autism in addition to anxiety, bipolar disorder and intermittent explosive disorder, among other diagnoses that cause these, at times, violent outbursts, according to Melody.

When she was born, Angeleena had microcephaly, and her brain was smaller than normal, Melody said. She also suffers from frontal lobe epilepsy where her seizures originate and that also contributes to her lack of impulsivity control. A formal autism diagnosis from a psychologist came in 2020.

Before Angeleena's arrest in the winter of 2022, Melody tried several times to get her daughter into hospitals or other treatment facilities but she was always told "No" for a variety of reasons: "They couldn't house her with the older kids because they were afraid she'd become a victim. They couldn't house her with the younger kids because they were afraid that she would hurt them."

Or there were long waitlists. Or, they didn't accept their insurance, or they couldn't take her because of her neurological disorder.

"It was always something," Melody said.

The program helps at-risk teen offenders with autism to stay out of the criminal justice system
That is until she heard about a specialty court program near her home called DAAY Court or the detention alternative for autistic youth treatment court. It's based in Las Vegas and not far from Melody's home.

Started by Judge Sunny Bailey in 2018, the Eighth Judicial District's diversion program aims to address the behaviors of at-risk juvenile offenders with autism and to prevent them from entering the revolving door of the criminal justice system as adults.

That is until she heard about a specialty court program near her home called DAAY Court or the detention alternative for autistic youth treatment court. It's based in Las Vegas and not far from Melody's home.

Started by Judge Sunny Bailey in 2018, the Eighth Judicial District's diversion program aims to address the behaviors of at-risk juvenile offenders with autism and to prevent them from entering the revolving door of the criminal justice system as adults.

The most common charges kids who come into DAAY Court face have to do with battery (usually at home or at school) or sex-related offenses (usually stemming from a lack of understanding of boundaries or proper behavior), according to Chief Deputy District Attorney Summer Clarke.

The court combines the efforts of social workers, therapists, probation officers, defense attorneys and prosecutors to address psychiatric needs, behavioral modification, socialization, and parent training to get to the root causes of the kids coming into Judge Bailey's courtroom.


"We all have to work together because autism is 24 hours a day. School can't fix this, home can't fix it, everyone has to fix it," Bailey said.

It's the first of its kind in the nation and, as of this summer, received recognition from Gov. Joe Lombardo which allows the program to get more funding. Lombardo's signature on Senate Bill 411 also allowed other jurisdictions across Nevada to create their own DAAY Court Program.

Since its inception, Bailey said 86 children have graduated the program with just six returning so far.

Angeleena is one of those kids who successfully completed.

For the first time, Melody has felt hope for her and her daughter's future.

"It was literally going from I'm bawling up in the fetal position in my bedroom at night after she went to bed, crying myself to sleep most days of the week to so many resources, I didn't know what to do with them. And it was so wonderful," Melody said.

The judge who started it all
The way Judge Bailey tells it, DAAY Court started completely by accident.

She was assigned the case of a child with autism facing a charge for domestic violence against his stepdad.

This was in 2018 and Bailey, the probation officers on this case and others familiar with the intricacies of individuals with autism knew that a crowded, loud, chaotic courtroom would be too much for a child with this diagnosis to handle.

“We were concerned about him being overstimulated," Bailey explained, which is when someone with autism becomes very overwhelmed by their environment, leading to distress and serious anxiety.

So Bailey set his hearing for a quieter Thursday afternoon where this child would be the only one in her courtroom.

Probation officers and other court workers heard about this accommodation and thought it was the start of a new "autism court." Bailey tried to explain it was a one-off but "the next thing you know, they put another kid on the calendar" who also had autism.

Every week it grew. More probation officers, social workers and behavioral specialists heard about this day set aside for autistic youth and began showing up wanting to help, Bailey said.

Soon enough, court administrators gave this once-a-month meeting a name: DAAY Court – Detention Alternative for Autistic Youth, "And that's kind of how we were born," Bailey said.

She said that there has been some interest elsewhere in the state and country for other courts to adopt similar programs, but it has not been formally adopted yet.

So far, it's helped children like Angeleena as well as the children of Amber Ayala and D. Lopez.

Research shows youth with autism come into more frequent contact with police
Lopez said she struggled to know how to help her son, 16, who has autism and who deals with mental health issues. Lopez requested NPR not name him over privacy concerns.

Much like Angeleena, he was arrested for a similar violent outburst. Having police involved in what is normally a mental health issue for her son, terrified Lopez.

"As they get older, they're not seen as a little kid that has autism anymore. They're seen as a danger," Lopez said.

Some research done by the A.J. Drexel Autism Institute at Drexel University found that youth with autism are coming into contact with law enforcement and the criminal justice system at higher rates as both victims and offenders.

And law enforcement officers are frequently not trained to properly deal with a child with disabilities having an episode, like Ayala's daughter, whom Ayala requested NPR not name out of privacy concerns.

Leigh Anne McKingsley, the senior director of disability and justice initiatives for The Arc raised some concerns about DAAY Court as a meaningful solution for helping youth with autism as they come into contact with law enforcement.

The fact that this program was created shows just how crucial the need is for more education in the U.S. criminal justice system on people with disabilities, she said.

"In the court system, we need folks to understand ADA accommodations and why those are so important," McKingsley said. "In a perfect world, police, prosecutors and judges would be equipped and trained to understand the needs of those with disabilities that come into contact with the criminal justice system."

Beyond that, McKingsley wonders if this idea of DAAY Court could have unintended, negative consequences.

She said that core to the disability rights movement is the goal of creating true societal inclusion, "Sometimes when we try to create a specialty or separate system, it can actually serve to kind of backfire, and have some long-term consequences that can steer us back to institutional thinking, or isolating people with disabilities or other-izing them," McKingley said.

This can, however, also serve to leave out the greater group of individuals with intellectual disabilities who fall through the cracks when their unique needs are not met in the same way as something like DAAY Court.

"We've got to look at it more holistically. And make sure that we're not alienating a part of the disability community when we're looking at trying to help people," McKingsley said.

An afternoon in DAAY Court
Bailey, to her credit, has a unique sensitivity to helping youth with autism because of her own experience.

"My eldest child is on the spectrum," Bailey said. Her daughter is now 25, but when she was first diagnosed in 2000 "there weren't any providers."

Her daughter also had aggressive behavior, which when Bailey documented it, totaled to more than 250 such incidents a day that led to several injuries.

"We've included, just on myself, four herniated discs on my neck, I've dislocated fingers. She put her head through the wall. We've had all kinds of issues with her," Bailey said.

After many years, Bailey found that Applied Behavior Analysis (ABA), a therapy based on the science of learning and behavior, that emphasizes behavior modification and positive reinforcements, as the biggest contributors to her daughter's change.

"She went from 250 of those aggressive acts per day, to maybe one per four or five months. So I know it works," Bailey said.

That's why this type of therapy option is a major aspect to the DAAY Court program.

Bailey uses ABA's main strategies: Positive reinforcement. She found that rewarding kids who meet certain goals between each appearance in her court makes a huge difference and gets the kids' buy-in from the start.

This method was put into action during a quieter-than-usual Thursday afternoon in DAAY Court in late October. Bailey and her cohort of attorneys, prosecutors, juvenile treatment program officers and probation officers are all on deck, both in person and over Zoom, for check-ins with a handful of kids currently working through the program.

When each child comes up for a check-in, Bailey goes through a checklist of goals each child was supposed to meet since the last hearing.

NPR is not naming any of these children as they are minors and their court cases are confidential.

One child, who NPR is calling CD, had an issue with running away from a facility he was staying in. But, on this Thursday, it's revealed that since his last check in he managed to stick to his agreement with Judge Bailey to not run away for two weeks.

Before he enters the court room, Bailey announces to the cohort on Zoom and in-person: "Everybody get ready for positive reinforcement!"

When CD enters, the group applauds and those over Zoom send in a barrage of happy emojis. For keeping his agreement, he gets to pick a $10 Target gift card from Bailey's collection.

Parents provide a key component to success
There are times that attorneys and probation officers are unsure if a child in their care has autism. If that's the case, they are brought to Bailey's court anyway where the first step is to get a proper diagnosis, the judge said.

Getting buy-in from family members is a major piece of the puzzle, Bailey said.

"Cases where we have parents who are ready, willing and able to cooperate and follow court orders and take kids to their appointments and do what they're supposed to do, I would say that we have 100% success rate," Chief Deputy District Attorney Clarke said.


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12 Feb 2024, 10:30 am

While well intentoined, ABA never made anything better in the long run.



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12 Feb 2024, 10:50 am

If the ABA is compulsory then how exactly is this any better than just sending them to jail?



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12 Feb 2024, 12:49 pm

Since this particular ABA program uses “positive reinforcement” it is a lot less bad than jail where autistics are extremely vulnerable to all sorts of narcissists, sociopaths, psychopaths etc. Jail is extreme sensory hell.

But a lot less bad is often still pretty bad. ABA trains one to be compliant. While behaviors that are a danger to oneself or others need to be dealt with often essential non violent essential elements of who one is suppressed leading to a range of psychological ailments.

Because ABA “works” in the short term that is what is observed. Long term harm has not happened yet so cannot be observed. That and since ABA is a monopoly pleas for programs that do good instead of less bad are greeted by the attitude of nothing to see there.


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“My autism is not a superpower. It also isn’t some kind of god-forsaken, endless fountain of suffering inflicted on my family. It’s just part of who I am as a person”. - Sara Luterman


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13 Feb 2024, 8:15 am

The Argument Over a Long-Standing Autism Intervention - New Yorker
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Quote:
When Tiffany Hammond was growing up in Texas, in the nineteen-nineties, other children teased her for how she spoke: she talked too softly, she talked in a monotone, she paused too long between words, she didn’t talk enough, she talked to herself. “Something’s wrong with her head,” kids would say. She was always fidgeting with pens or Troll dolls. She tried to connect with her peers by taking on their interests as her own—the Goosebumps series of scary novels, the N.B.A.—but the attempts backfired, as when she printed out an N.B.A. schedule, laminated and color-coded it, and brought it to school as a conversation piece. She kept a notebook on “how to be human,” which included tips such as remembering to staple your worksheets at the top-left corner and acquiring a pair of the correct Filas. Nothing worked. “I wondered why I didn’t have friends, or if I even deserved friends,” Hammond said. She dreaded school so much that, on a few mornings, when she was supposed to be walking there, she instead tried to make it to her great-grandparents’ house, some twenty-five miles away.

When Hammond was twelve, she took an overdose of Tylenol. She told me that she’s not sure if she intended to attempt suicide; she just wanted the noise and negativity in her head to stop. Her mother brought her to doctors who gave Hammond a prescription for Paxil and a diagnosis of Asperger’s syndrome, which, at the time, was recognized as an autism-related disorder that affects communication and social-emotional skills. She began going to a clinic for therapy twice a week, and continued for two years. “It was, ‘You have to sit right in the chair, you can’t cross your legs this way, you have to enunciate, no fidgeting,’ ” Hammond said. She might be asked to practice speaking clearly by reading the same paragraph from “Charlotte’s Web” out loud, over and over, and then do it again the next session. The work was tedious and difficult. “As a kid, you think, Why am I like this? Why can’t I get it?” Hammond said. “And then you have those times when you’re, like, Why can’t they just let me sit the way I want to sit?”

It was not until she was in her late twenties that Hammond, an autistic advocate who is the author of the best-selling picture book “A Day with No Words,” realized that her childhood therapist was practicing something called Applied Behavior Analysis. A.B.A. therapy aims to build skills and habits that many autistic people do not have by breaking tasks down into small steps and reinforcing desired behaviors through repetition and rewards, which, with little kids, could take the form of candy or extra time with a favorite toy. Hammond had aged out of such incentives by the time she was enrolled in A.B.A., but earning praise from her therapists was reinforcement enough. “I wanted to please these adults. I wanted people to feel good being around me,” she said.

A.B.A. is the only autism intervention that is approved by insurers and Medicaid in all fifty states. The practice is widely recommended for autistic kids who exhibit dangerous behaviors, such as self-injury or aggression toward others, or who need to acquire basic skills, such as dressing themselves or going to the bathroom. The mother of a boy with severe autism in New York City told me that her son’s current goals in A.B.A. include tolerating the shower for incrementally longer intervals, redirecting the urge to pull on other people’s hair, and using a speech tablet to say no. Another kid might be working on more complex language skills by drilling with flash cards or honing his ability to focus on academic work. Often, A.B.A. targets autistic traits that may be socially stigmatizing but are harmless unto themselves, such as fidgeting, avoiding eye contact, or stereotypic behaviors commonly known as stimming—rocking, hand-flapping, and so forth.

Hammond is now the mother of two autistic sons. Her older son, Aidan, who is sixteen, is nonverbal and needs round-the-clock care. When he was young, he attended a traditional school, but teachers, Hammond said, “were literally calling me every single day: ‘Can you please come here and sit with him? Can you please pick him up?’ ” Hammond tried physical, occupational, and speech-language therapy for Aidan, but he was “kicked out of every single one,” she said. Therapists “felt that his behaviors were interfering with his learning, and that he needed to be in A.B.A.” A.B.A. clinicians, she added, “were at least willing to look at my son.”

She drove him to A.B.A. appointments at a clinic about an hour from their home in southwest Texas, but stopped treatment after just a few sessions. This was partly due to the commute and the co-pay, but also to a discomfort with the approach, which required Aidan to spend long periods, over multiple sessions, solving a puzzle in which he matched shapes to the right-sized holes. “He’s having to do this over and over and over again,” Hammond recalled, “and, when he picked the right thing, it’s, like, Ooh, here’s a Skittle! Like he’s a puppy.”

In recent years, A.B.A. has come under increasingly vehement criticism from members of the neurodiversity movement, who believe that it cruelly pathologizes autistic behavior. They say that its rewards for compliance are dehumanizing; some compare A.B.A. to conversion therapy. Social-media posts condemning the practice often carry the hashtag #ABAIsAbuse. The message that A.B.A. sends is that “your instinctual way of being is incorrect,” Zoe Gross, the director of advocacy at the nonprofit Autistic Self Advocacy Network, told me. “The goals of A.B.A. therapy—from its inception, but still through today—tend to focus on teaching autistic people to behave like non-autistic people.” But others say this criticism obscures the good work that A.B.A. can do. Alicia Allgood, a board-certified behavior analyst who co-runs an A.B.A. agency in New York City, and who is herself autistic, told me, “The autistic community is up in arms. There is a very vocal part of the autistic population that is saying that A.B.A. is harmful or aversive or has potentially caused trauma.”

Until recently, the American Medical Association officially endorsed “evidence-based treatment of Autism Spectrum Disorder including, but not limited to, Applied Behavior Analysis Therapy.” Last summer, the medical students’ body of the association proposed that the organization withdraw its support for A.B.A., citing objections by autistic self-advocates. The association did not adopt the resolution as submitted, but its house of delegates eventually approved an amendment removing any explicit reference to A.B.A., and autistic activists spread the word that A.B.A. no longer appeared to have the outright endorsement of the nation’s largest medical society.

Alison Singer, who is the president and co-founder of the Autism Science Foundation, believes that criticism of A.B.A. has gone too far.

A lot of kids with autism are not able to wait their turn,” Singer told me. “In A.B.A., she learned, over time, that firstwe will do this, and then we will do this”—for example, first, we’ll practice some new words, and then we can have some free time on the iPad. The intervals between “first” and “then” might begin at just ten seconds, then build up to thirty seconds, then one minute, and so on.

A generation ago, Singer said, “everyone who was diagnosed with autism got A.B.A. That type of one-size-fits-all treatment never really made sense for a child who had intact language or a high I.Q.” Now those children have grown up. “They’re talking about A.B.A. and how negative it was for them. But that doesn’t mean that we should eliminate it for the people who need it.” Singer’s position is, in part, a pragmatic one, but the debate over A.B.A. goes beyond practicalities. It is not simply a matter of whether a particular treatment works but what it means to be autistic, and what all autistic people do, or do not, have in common.

The origins of A.B.A. are undeniably disturbing. The person most closely associated with A.B.A.’s genesis is O. Ivar Lovaas, a clinical psychologist at U.C.L.A. who worked with severely autistic children. Beginning in the nineteen-sixties, Lovaas sometimes used “aversives”—shouting, slaps, and even electric shocks—to punish tantrums, stimming, and inattention in his child subjects. (Today, the Judge Rotenberg Center, in central Massachusetts, is believed to be the last institution in the U.S. that still administers electric shocks as part of A.B.A. therapy.) Some of the children in Lovaas’s care were not served regular meals, only receiving spoonfuls of food, such as sherbet, as rewards for complying with commands. And Lovaas openly shared appalling views of the autistic children he treated, once telling an interviewer that “they are not people in the psychological sense.”

In 1987, Lovaas authored a seminal study of sixty autistic children. In it, nearly half of the kids who were treated with an A.B.A. technique known as discrete trial training became, in Lovaas’s words, “indistinguishable from their normal friends.” “We would argue that that’s not a good goal in the first place,” Zoe Gross noted, dryly, “but, even for what it purports to do, which is to reduce the quote-unquote symptoms of autism, A.B.A. has not been rigorously proven to be good at that.” There is ample research, collected over decades, supporting the efficacy of A.B.A., but much of it is based on small studies and what are known as single-subject designs, in which subjects effectively serve as their own control group. Weighing the data also becomes more complex owing to the proliferation of A.B.A. subgenres, which tend to be more play-based and less repetitive than old-school A.B.A.

An idiosyncrasy of A.B.A. is that, often, the highly credentialled analyst is not the person directly providing service to the client; rather, the analyst supervises groups of lower-skilled behavior technicians. “The logic was that anybody could do A.B.A., and it can be cheap, because these are basic principles of behavior that you can use with a rat,” Catherine Lord, a professor at U.C.L.A. who studied under Lovaas as an undergraduate, told me. (“It’s not true,” she added.)

In recent years, private equity has taken a voracious interest in A.B.A. services, partly because they are perceived as inexpensive. Private-equity firms have consolidated many small clinics into larger chains, where providers are often saddled with unrealistic billing quotas and cut-and-paste treatment plans. Last year, the Center for Economic and Policy Research published a startling report on the subject, which included an account of how Blackstone effectively bankrupted a successful A.B.A. provider and shut down more than a hundred of its treatment sites. Private-equity-owned A.B.A. chains have been accused of fraudulent billing and wage theft; message boards for A.B.A. providers overflow with horror stories about low pay, churn, and burnout. High rates of turnover are acutely damaging to a specialty that relies on familiarity between provider and client. “The idea that we could just franchise A.B.A. providers and anyone could do the work—that was misinformed,” Singer, of the Autism Science Foundation, said.

Some autistic people are trying to change the field from within. Armando Bernal, who is autistic and runs an independent A.B.A. clinic outside Houston, doesn’t work on helping clients make eye contact—in fact, he tends to avoid it himself. He also flaps his hands when he gets excited. (If a parent is concerned about their own child’s stimming, Bernal tries to put them at ease by telling them that his hand-flapping is how his fiancée knows that she’s got him the perfect Christmas or birthday gift.) He’ll work on stereotypic behaviors only if he’s convinced that they’re disruptive—for example, if a child is stimming in certain school settings. “I don’t agree that it forces people to be less autistic to focus on these behaviors,” he said. “It allows these children to be successful and independent while being able to manage themselves in a space with neurotypical individuals.”

Allgood, another autistic A.B.A. provider, spent the early months of the pandemic speaking with people who oppose A.B.A., then hired autistic self-advocates to tutor her staff. Her clinic does not use food rewards, partly owing to concerns that they can contribute to eating disorders. “Eye contact, I really don’t care,” she told me. “I have met so many doctors who don’t look at me.” Her agency has also moved away from a technique known as extinction, in which unwanted behaviors are simply ignored; the hypothesis is that if, for example, a child’s meltdowns are denied the oxygen of attention, they will cease to exist. But, Allgood said, “I’ve come to learn how damaging extinction can be,” because it doesn’t address challenges native to autism—such as sensory triggers or underlying executive-function issues—that may be causing the meltdowns in the first place. “It is the last moment that we should be turning our backs on you,” she said.

“Autistic people are not the sum of their behaviors,” Paige Layle, a neurodiversity activist in Ontario, told me. “If you change the behavior, the autistic person still has all those same feelings and all the same reactions.” Layle has nearly three million followers on TikTok and is the author of the forthcoming memoir “But Everyone Feels This Way.” After she was diagnosed with autism, at the age of fifteen, Layle underwent A.B.A. therapy that focussed on socializing: how to read social cues, how to avoid making blunt or hurtful comments, and so forth. “I was like, I’m sorry that I offend people so much, and I would love people to like me, but that’s not my main problem—like, I want to like me,” Layle, who is now twenty-three, said. “I want to learn how I can emotionally regulate myself so I don’t get angry, so I’m not having panic attacks, so life isn’t so hard.” Sometimes her therapist, noticing that she was becoming frustrated, would suggest a short break, and walk away. The message, Layle said, was “that when I’m upset, people will go away, and I have to be happy for people to pay attention to me.”

Layle expressed support for autistic therapists who are working to reform A.B.A., but other self-advocates are more dubious. “The people who claim that they’re neurodiversity-affirming, I think you’re going to find that those people are not doing A.B.A., but labelling it that for insurance purposes,” Gross, of the Autistic Self Advocacy Network, said. This work-around, she went on, may at times seem “like a parent’s best option. Technically, it’s also insurance fraud. It’s not a policy solution.”

A.B.A.’s strongest detractors and supporters often seem to be describing two completely different phenomena. The autistic self-advocates describe a coercive practice that forces kids to smother who they are for the comfort of those around them. The parents of kids with high support needs describe a life-altering intervention that has taught their child how to put on her shoes, or how to communicate a need or desire in ways that don’t involve banging her head against a wall or hours of screaming.

This schism is a microcosm of a larger, equally contentious debate over how to define autism itself.

This schism is a microcosm of a larger, equally contentious debate over how to define autism itself. In 2013, the DSM-V retired several autism-related diagnoses, including Asperger’s syndrome, and created a new, single category: autism-spectrum disorder. “When the DSM-V lumped everyone together, it did a disservice,” Singer said. She advocates for the DSM-VI, whenever it may arrive, to break off a new diagnosis from the spectrum, called profound autism, to describe a person who requires constant supervision and has limited cognitive and verbal ability. “The umbrella term ‘autism-spectrum disorder’ provides absolutely no information about a person’s functional level or their needs,” she said.

A new category is also necessary, Singer told me, because some neurodiversity advocates “intentionally advocate against recognizing the suffering and acute needs wrought by profound autism.” She went on, “The truth is that, for some people, autism may be a gift, while the simultaneous truth is that for other people autism symptoms are a tremendous burden, a lifelong disorder, for which society should seek understanding, prevention, and medical intervention.”

The Autistic Self Advocacy Network and other like-minded organizations largely reject the concept of profound autism. “It’s an attempt to make autism into these two monolithic categories, whereas autism is one heterogeneous spectrum,” Gross said. She is concerned that an official designation of profound autism might be used by health insurers and social-service agencies as a pretext to limit services to those who lack the diagnosis, and that it risks segregating certain autistic people from their communities.

This line of thinking seems to take for granted that all autistic people can successfully communicate what they want. Tiffany Hammond has come to question whether it genuinely accounts for the challenges that many autistic people face. “There are really loud voices in the community that almost make autism seem like it’s a personality quirk, and that society is the only thing that disables us,” she told me. “They’re not leaving space for my son’s experience.” Although Hammond ultimately pulled Aidan from A.B.A. therapy, she believes that some strains of the anti-A.B.A. movement have become divorced from reality. “Advocates say, ‘There’s better ways than A.B.A.,’ and I’m, like, ‘Where are the better ways?’ They don’t know the systems that we have to navigate. They just kind of talk.

Hammond and her sons are Black, and she likened some of A.B.A.’s lessons to the masking and code-switching that Black people have to do all the time. “You learn to be different people, because you have to get a job and put a roof over your head, and all you have to do is be a muted version of yourself for xhours a day.” A.B.A. may emphasize conformity and compliance, but, then again, Hammond said, “we live in a compliance-based society.”

For Hammond’s family, the question of compliance might have terrifyingly high stakes. More than once, she said, when she is with Aidan in public, people have called the police or security. “My kid does not know how to mask, he doesn’t know how to rein it in, he’s loud, he’s animated, he’s all over the place, and he doesn’t speak. When the cops come, he might be running in circles, he might be reaching for his iPad, and they’re reaching for their firearms. Are you going to try to change the cops, or are you going to try to change my son?” She added, “A.B.A. is just a symptom. It’s a leaf of a tree with rotted roots.”


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“My autism is not a superpower. It also isn’t some kind of god-forsaken, endless fountain of suffering inflicted on my family. It’s just part of who I am as a person”. - Sara Luterman


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16 Feb 2024, 8:28 am

ASPartOfMe wrote:
Since this particular ABA program uses “positive reinforcement” it is a lot less bad than jail where autistics are extremely vulnerable to all sorts of narcissists, sociopaths, psychopaths etc. Jail is extreme sensory hell.

But a lot less bad is often still pretty bad. ABA trains one to be compliant. While behaviors that are a danger to oneself or others need to be dealt with often essential non violent essential elements of who one is suppressed leading to a range of psychological ailments.

Because ABA “works” in the short term that is what is observed. Long term harm has not happened yet so cannot be observed. That and since ABA is a monopoly pleas for programs that do good instead of less bad are greeted by the attitude of nothing to see there.


Actually, the long term harm is starting to come out of the woodwork.

https://www.researchgate.net/publicatio ... r_analysis

About half of kids put through ABA end up with PTSD. Half of those have severe symptoms. It positively correlates to the length of therapy. There is a lot of research now. ABA is turning out to be a lot like beating kids for discipline in that the best you can say about it is "it causes more problems than it solves."



autisticelders
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16 Feb 2024, 8:42 am

watching with interest. Would other kinds of therapy be even more effective? Makes you wonder. If trauma from this particular program that uses positive reinforcement happens, I wonder where that comes from? watching with interest. there are so many questions and so few answers. This sort of therapy seems preferable to being locked in padded cells in isolation. I think the key may be education of parents/ caretakers and their complete participation in the programs. Understanding the individuals neurology and triggers, and learning better ways to communicate, better ways to interact when the individual is distressed, etc (throw her over my shoulder, restrain her) may have a lot to do with success of this program. still watching. Thanks for this post and for all the good topics you bring to our attention.


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16 Feb 2024, 10:29 am

autisticelders wrote:
watching with interest. Would other kinds of therapy be even more effective? Makes you wonder. If trauma from this particular program that uses positive reinforcement happens, I wonder where that comes from? watching with interest. there are so many questions and so few answers. This sort of therapy seems preferable to being locked in padded cells in isolation. I think the key may be education of parents/ caretakers and their complete participation in the programs. Understanding the individuals neurology and triggers, and learning better ways to communicate, better ways to interact when the individual is distressed, etc (throw her over my shoulder, restrain her) may have a lot to do with success of this program. still watching. Thanks for this post and for all the good topics you bring to our attention.


To see it, I respectfully suggest a wider view. Don't look only at those who are in danger of incarceration; rather, look at all who are put through the ABA program as a whole. Look at the collective outcome.

ABA advocates are trying to claim that positive reinforcement is the only thing used and it isn't coercive, but ask yourself this. How many kids in these programs voluntarily consent to the treatment especially once it is underway? How many think it was a good choice after it is over?

How many medical programs with such a high rate of problems and post-treatment rejection by the patients are considered good choices?

In some cases, ABA solves some short-term problems if you put some dubious conditions on that claim (like IQ 70+ verbal only), but in a vast number of cases, it causes more problems than it solves, and the problems it causes tend to be permanent.

Which would you prefer for yourself or your child? A 5% chance of being prosecuted or a 46% chance of PTSD?