The Australasian Society for Autism Research has just released "A Review of the Research to Identify the Most Effective Models of Practice in Early Intervention for Children with Autism Spectrum Disorders" which assesses the research evidence in support of the various early autism interventions and rates the interventions according to the level of evidence base in support of each intervention.  As with every other major research review of the effectiveness of early autism interventions only ABA, applied behavior analysis, received the highest rating:

All credible reviews of autism interventions from the US Surgeon General to the American Academy of Pediatrics, Management of Children with Autism Spectrum Disorders (2007, confirmed 2010) have rated ABA highest of all early interventions for autism disorders. Only ABA has consistently, as in this Australiasian review, been placed in the highest category in this case described as "Established based on Evidence".  This review, like all other reviews of the research literature before it, is unlikely to change the minds of the anti-ABA ideologues but it is important as one more tool to support political and legal advocacy aimed at providing education and health benefits for autistic children and adults.  Thank you to Dr. Jon Brock a member of the ASfAR executive committee for highlighting this new research report via Twitter. 

I am forwarding the above composite picture of my son Conor, seated in the kitchen watching the clock at 7:30 am this morning.  Conor, now 16 years old, has severe Autistic Disorder and is assessed with profound developmental delays.  He was not placed on a "time out" chair for having behaved badly.  He was sitting there of his own choice because he was, as he is every day, anxious to get to school at Leo Hayes High School, an experience he truly loves and one which he misses during the summer months.  

I encouraged Conor to engage in other activities instead of just sitting on the chair and he did so. At precisely 7:55 though Conor, again on his own initiative, brought me a pair of my sneakers and handed them to me,  as a polite reminder to Dad to get ready to take him to school. To the far left of the picture is a red object. It is his school back pack including his lunch pack which he packs the night before and placed in the fridge.  In the morning, on his own initiative, he places the lunch pack inside the back pack and places them near the exit door to ensure that it is with him when Dad drives him to school in the morning.  

With these actions Conor indicates clearly what a positive experience his flexible inclusive education at Leo Hayes HS is for him.  Conor does not, at our request receive his instruction in a regular classroom. Some autistic children can prosper in a regular classroom and some, like Conor, require instruction outside the regular classroom in a quieter space where he is not overwhelmed by noise and other distractions. 

Conor started his schooling in a regular classroom and came home every day with self inflicted bite marks  on his hands and wrists. (self injurious behavior is a recognized condition commonly associated with autism disorders). Once removed the biting ceased and Conor received his instruction in an individualized area in grade school, middle school and high school.  His instruction has been provided by education assistants/teacher aides trained at the excellent UNB-CEL Autism Intervention Training program.  

Conor's socialization has NOT been impaired by these arrangements.  Throughout school he has, in consultation with us, his parents, been involved in various outings and activities within his abilities including some specified gym activities, swimming (his favorite), outings like apple picking (another favorite) and last year he even attended a play put on at Fredericton's playhouse. Other students have ALWAYS greeted Conor warmly at every level of school. Some have even sought him out at our home in order to say hello to him outside of school. At Tim Horton restaurants Conor has been greeted by staff who are were students at school and knew him through Best Buddies. I underline these facts because it is important to realize that full regular mainstream inclusion is NOT necessary to ensure a full social learning experience for children with severe challenges like my son.  

One of the greatest socialization assets for Conor has been the Resource Center at the Leo Hayes High School. The RC is well staffed with trained experienced personnel that know how to manage children with extra needs in as stress free a manner as possible.  It also provides a variety of tools and sharing of information directly by people who are actually working directly with challenged children.  Stigmatization does not occur by placing challenged children in a resource center for parts of the day.  Stigmatization and outright harm occurs by pretending that all children regardless of cognitive level and regardless of disability based sensory and behavioral challenges,  must receive instruction in the same area as their chronological "peers". 

I have made these statements again on Conor's behalf, as I have made them throughout his education because of the constant threat posed to the flexible mode of inclusion that has benefited him in his education. The ideologically based every child in the regular classroom model to which this current administration and its most trusted advisers subscribe would be detrimental and harmful to my son if inflicted upon him, if his ABA based learning in an alternative area or if his socialization, security and happiness in the Leo Hayes High School are targeted for elimination.

Conor demonstrates the success of the current flexible model of inclusion, of the ABA instruction he has received outside the regular classroom, of the security and opportunity for socialization that the Leo Hayes High School Resource Center provides.  Please do not ignore Conor's story while making decisions affecting his future and the future of other children who need accommodation outside the regular classroom.

Although I am a lawyer by profession I try to avoid making legal arguments in education discussion since they can unfortunately lead to confrontation when cooperation and understanding are so badly needed to ensure proper education and development of children.  Having said that I will provide you, with respect, to two links to documents summarizing leading precedents in Canadian jurisdiction concerning the need meaningful access to education of children with disabilities written by Yude Henteleff QC a distinguished lawyer and Order of Canada member who has represented many disability organizations in Canada. Without getting too detailed I believe these documents can be summarized by saying that case law has established that an ideological insistence on regular classroom placement of all children regardless of disability considerations, and without providing alternative arrangements to accommodate their disability based challenges can constitute unlawful discrimination:

I would ask you foremost though to simply look at these pictures of Conor and take my word as his parent, as a long time autism advocate and representative of the Autism Society New Brunswick during the MacKay and Ministerial Committee inclusive education reviews (and current acting ASNB President). Not all children, and certainly not ALL autistic children function well in the regular classroom.   The ASNB position that children should be educated in a manner consistent with an evidence based determination of their best interests is consisted with the policies of the Canadian Learning Disabilities Association. It is also consistent with the first section of the PNB definition of Inclusive Education that resulted from the Ministerial Committee review of inclusive education:

I ask both of you Honourable Ministers to be faithful to the above definition of inclusive education fashioned after years of consultation conducted by Ministers of the Lord and Graham governments and examined the evidence of my son and other children with needs that require education outside the regular classroom.  Please continue the option for individualized education outside the regular classroom for those like my son who require that arrangement.  And please do not eliminate valuable, proven resources like the Leo Hayes High School Resource Center that have contributed so much in the way of socialization, security and friendship for my son and others with similar needs.

Respectfully,

Harold L Doherty

Fredericton NB

Dr. Davies is a clinical psychologist with actual experience working with children with autism. There are lots of purely academic, research psychologists working solely with abstractions and epidemiological statistics. It is important to listen to  experienced clinical psychologists like Dr. Davies, psychologists who understand the realities and challenges of autism disorders and the best known way to address those challenges ... ABA treatment.

A Nova Scotia mother with an autistic son is planning to "go out to Alberta" where ABA autism treatment services are not, as in Nova Scotia, limited to one year.  Does Canada need Medicare for Autism NOW?  No question about it.  Nova Scotia, for those who don't know, is also the province which became notorious for distributing ABA services for autism on a lottery basis. 

I was born in Nova Scotia's Annapolis Valley and return  periodically to visit family. It is a beautiful province with some wonderful people but it's government has not made proper treatment of autistic children a significant priority.  Canada needs Medicare for Autism Now so that more families with autistic children are not forced to leave provinces like Nova Scotia or New Brunswick which is now, under the Alward government,  effectively dismantling many of its autism services.

Barry Hudson is  a very well informed, articulate father of an autistic son in Ontario, autism advocate and director with Medicare for Autism Now! Barry describes his family life with autism and the impact of autism on family life.  He describes waiting lists and other obstacles that the Ontario bureaucracy uses to prevent children with autism from receiving autism services.  Children with autism who are not considered severe enough do not receive treatment. Children with autism who are considered too severe do not receive treatment.  A child with autism who clears these hurdles will have treatment services discontinued if they do not pass periodic improvement tests.  

Barry also provides an informed articulate history and criticism of Canada's failure to provide a national health care scheme to cover autistic children in Canada, a failure made more pronounced by the fact that some other countries have identified autism as national priorities and put programs in place to provide treatment.  

I was fortunate, and my son Conor was fortunate, that not too long after his autism diagnosis I attended an autism parent meeting where I met a registered nurse named Dawn Bowie. Dawn's autistic son was a couple of years older than Conor. When I began expressing some of my doubts about early intervention, doubts inspired by reading Neurodiversity literature, Dawn Bowie responded as perhaps only a nurse can do. She looked me right in the eye and in a very firm tone said "You listen mister you get treatment for your son, if you can, as much as you can".

There weren't many autism treatment resources available in Fredericton 14 years ago when my son was diagnosed at the age of two. But I sought out the treatment that Dawn recommended and I became an advocate for autism services in New Brunswick along with Dawn Bowie and many other autism parents. As the parent of a now 16 year old son I don't know if he could have attended school all these years, or if he would still be living with us, if he had not received the ABA he has received and if we had not learned how to manage his behavior through our own efforts to apply ABA principles at home. 

Early effective ABA intervention for your autistic child. It's the best advice I received for my autistic son. Absolutely check with your child's treating professionals but I suspect you will receive the same advice ... get as much early ABA treatment for your autistic child as you can. It was the best autism advice this father of a severely autistic son ever received. 

My previous commentary on the irrationality of, and harm caused by, Neurodiversity follows. It includes references to an American Medical Association commentay in which Dr. Magaret Moon questions the ethics of parents refusing available effective ABA treatment for their autistic children, parents who have imbibed the anti-cure rhetoric.  My comment also includes an earlier reference to Dawn's advice ... the best autism advice I ever received. 

This is the video of my interview on Medicare for Autism Now! Since that interview a US Federal Court Judge has ordered Florida Medicaid to provide Medicaid coverage of ABA for autism. California has mandated insurers to provide ABA coverage for autism and the US federal government has done the same thing in respect of US federal government employees. Meanwhile back in Canada .... nothing ... or worse. 

The sham autism symposium held after a panic stricken Canadian government cancelled a real national autism symposium in order to screen out and prevent real autism activists from attending has resulted in absolutely no gains for autistic Canadians. Little progress has been made across Canada and in some provinces, like New Brunswick under the current administration, we are actually seeing gains slip away. 

We need a new generation of advocates to step forward and join the fight for autistic children and adults. We need YOU!

I strongly encourage anyone with an autistic child or interest in autism services in Canada to watch this video by Jean Lewis, Canada's foremost autism advocate, who has lived and led much of the autism advocacy in Canada over the last decade. 

Jean is extremely well informed, articulate and authentic. She has lived the reality of severe autism and related disorders with her child and she, and her husband Michael, have fought with intelligence and determination to bring services to autistic children and adults in BC and across Canada.

At one time the argument might have been made that Canada led North America in terms of provision of evidence based treatment for autism.  Strong parent advocacy had made gains in encouraging provincial governments in British Columbia, Alberta and New Brunswick to provide Applied Behavior Analysis treatment. Our federal government, however, refused to get involved in any meaningful way and the Harper government played politics with the National Autism Strategy. The pitiful National Autism Symposium was postponed to allow the deck to be stacked with anti-ABA advocates and to weed out ABA advocates including me.  Here in New Brunswick our successful provincial program for early intervention based on the recognized (Eric Larsson, David Celiberti) UNB-CEL Autism Intervention Training program has  been abandoned at both the early intervention and school levels in favor of  in house autism intervention "training". In New Brunswick gains made are being abandoned, in Canada federally they never started.  In the Courts our Supreme Court of Canada, apart from a human rights and statutory analysis,  opined in Auton that ABA was an "emergent" therapy, notwithstanding earlier findings by the US Surgeon General, among other prominent authorities, that ABA effectiveness as an autism treatment was backed by 30 years and hundreds of studies.

Our good neighbors to the south, however, are taking autism disorders more seriously with more states requiring insurance providers to include ABA treatment and a 2012 federal judge ruling ordered that Medicaid cover ABA treatment in Florida.  Now Autism Votes, an Autism Speaks initiative, reports that the US federal government has concluded that ABA is primarily a medical, not just educational, therapy with the result that autistic persons among the 8,000,000 US federal employees will be eligible for ABA treatment under their medical coverage: 

It is hard to believe that in 2012 a government agency with responsibilities for the provision or administration of health care could take the position that ABA is an "unproven" treatment for autism.  That was the justification though of the Florida Agency for Health Care Administration in refusing to provide Medicaid coverage for ABA treatment for three persons with autism.   As reported  by the Miami Herald US Federal Judge Joan Lenard disagreed and ordered the FAHCA to provide the Medicaid coverage for the applied behavior analysis treatment: "U.S. Judge Joan Lenard ruled Friday that applied behavioral analysis be covered by Medicaid....Lenard held that ABA was a proven and highly effective treatment of children with autism."

Apparently the Florida Agency for Health Care Administration is not familiar with authorities from the US Surgeon General to the American Pediatric Association and  a number of state agencies that have reviewed the scientific literature and found ABA to be the most evidence based effective treatment for autism.  Or perhaps they   accidentally  subscribed to updates from anti-ABA activists Michelle Dawson and Laurent Mottron who have appeared (often) in the media and in Canadian legal and political proceedings in a prolonged and determined effort to prevent Canadian autistic children from receiving ABA treatment for their autism disorders.    Regardless, US Federal Judge Joan Lenard, in addition to issuing an order directing the agency to provide Medicaid coverage for ABA, has also educated the agency on the benefits of ABA treatment for children with autism disorders. 

Please watch Medicare's Orphans which details the fight for inclusion of health care treatment for autism disorders in Medicare in Canada and specifically the fight for medicare coverage of ABA. The medicare coverage of  ABA treatment for autism disorders is important because:

While this Canadian autism father is annoyed by media attention given to Canadian researcher  Laurent Mottron's perpetual crusade to recreate autism disorders in the image of his mentor Michelle Dawson, and trivialize the plight of the 70% of persons with Autistic Disorder and intellectual disabilities, there is good news south of the border to brighten the day.  In New York state BuffaloNews.com reports that our sensible American neighbors have passed legislation requiring insurers in that state to cover treatment for autism disorders:

Unfortunately in Canada the views of Dr. Laurent Mottron and his mentor Michelle Dawson concerning ABA treatment of autism disorders hold great sway with the government of Prime Minister Harper which invited them to the national autism symposiums from which Canadian ABA advocates were banned despite having fought for a national autism strategy which led to the symposiums. 

In Canada the fight for ABA coverage for autism disorders continues though and determined parents and professionals will not give up. Although the mainstream media loves the feel good picture of autism created by Neurodiversity ideologues like Mottron and Dawson a history of the struggle for treatment for our autistic children can be found online at Medicare's Orphans. 

On November 1, 2011 the film Medicare's Orphans was released by Medicare for Autism NOW! It is an excellent presentation of the history of the fight for medicare coverage of autism treatment in Canada and includes comments about the Supreme Court of Canada's monumental failure, in the Auton decision,  to ensure that Canadian governments provide coverage for treatment for autism disorders, a serious and disabling condition for many who suffer from it.


Medicare's Orphans. from MedicareForAutismNow on Vimeo.

Following is a reprint of a comment I posted on March 28, 2009 which reviewed the Auton decision in which the Supreme Court of Canada turned their back on our children with autism. 

The comment includes a stinging criticism of the Auton decision in a submission to the United Nations Committee on Economic, Social and Cultural Rights as part of the Committee's 2006 Review of Canada’s Fourth and Fifth Periodic Reports Under the ICESCR (International Covenant on Economic, Social and Cultural Rights) by the CCPI a national committee of  low-income individuals, anti-poverty organizations, researchers, lawyers and advocates for the purpose of assisting poor people in Canada to secure and assert their rights under international law, the  Canadian Charter of Rights and Freedoms ("the Charter"), human rights legislation and other law in Canada.

Apparently when pharmaceutical company executives contemplate the Autistic Disorder which limits the life of my son,  and the lives of many who suffer from the limitations imposed by Autistic Disorder, they see Autistic Disorder Therapeutic Market Opportunities, as described in thepharmaletter:

Translating from Pharma Speak ($$$) into one of the known human languages (English): pharmaceutical corporate profits should continue to rise with increases in Autism Spectrum Disorder diagnoses. Not to worry about ABA and other behavioral interventions ... "preferred" options ... depriving "pharma" (their expression not mine) of profits.

I hope pharma will forgive me. When I see my son I do not see an Autistic Disorder Market Opportunity I see a wonderful and amazing boy who has enriched my life in a way not contemplated in pharma newsletters.  I don't see $$$ when I see my son.  I see his amazing smile, his laughter, the joy he brings us each day.

The fight to ensure that children with autism disorders receive treatment for their disorders engages many different people with many different priorities.  Autism advocates do meet political leaders and civil services officials who genuinely care.  But we also encounter those whose only concern is the bottom line, the mighty dollar.  To persuade these people that autistic children deserve treatment for their autism disorders you have to speak their language.  That is exactly what Jacobson, Mulick and Green did in 1998 with their paper Cost-Benefit Estimates For Early Intensive Behavioral Intervention For Young Children With Autism-General Model And Single State Case, Behavioral Interventions, Behav. Intervent., 13, 201-226 (1998)(headnote):

I have criticized all aspects of mainstream media misrepresentation of autism including the tendency to hide the evidence based effectiveness of ABA known for many years and confirmed by authorities from the US Surgeon General to the American Academy of Pediatrics.  It is only right that I acknowledge, with gratitude, when a mainstream media institution gets it right as the LA Times has done with its clear, straight to the point,  statement about the importance of ABA as a treatment for autism disorders:

"An autism treatment worth funding


Editorial


A California bill would require insurance companies to cover the cost of applied behavioral analysis for the autistic. It's good policy.


September 30, 2011


State law requires insurers to include coverage for autism in comprehensive healthcare policies. Now, lawmakers want to go a step further, requiring coverage of a particular autism treatment: applied behavioral analysis. Insurers are resisting. They don't question the effectiveness of the therapy; they just say it doesn't fit the definition of "medical" treatment. Their position reflects how crucial parts of the healthcare system are wedded to the status quo, regardless of what's best for patients. State lawmakers have passed a bill to overcome the insurers' resistance, and Gov. Jerry Brown should sign it."

Dr. Freeman's blog promises to rapidly become one of the best autism blogs on the internet.  Her writing style is direct and does not cater to political correctness. A good example is a comment posted yesterday called "We're Aware Already!" in which she offers sound advice to Autism Speaks on two important points. 1. The need to educate ... sorry .... encourage ... many pediatricians to drop their opposition to routine early screening for autism. 2. Start publicizing the fact that ABA has been recognized as best autism practices since 1999 by the US Office of the Surgeon General and other key agencies:

I have already listed Autism Pundit on my sidebar as one of my favorite blogs to visit. If you are interested in helpful autism commentary I recommend Autism Pundit a blog which is serious about helping autistic children and adults written by someone who is extremely well informed, experienced in real autism advocacy, and who is a top notch writer. I encourage you to take a look at Autism Pundit and make it one of your regular blogs to visit.