Susan's Blog

Wednesday, May 28, 2014

No Wholesale Blame; Instead, Reframe

The Washington Post, which ran a story last week about how a new study is attempting to tie autism to serial killing. The Post published the article even though researchers involved were quick to point out that their work was nowhere near complete. And for those who had the patience to read through to the end, it also became clear that the study was based on some very spurious techniques (such as looking at certain historic killers and speculating about their lack of eye contact, their inability to empathize). To its credit, the Post quoted The Autism Society of America, a longtime advocacy group with this response: “To imply or suggest that some linkage exists is wrong and is harmful to more than 1.5 million law-abiding, nonviolent and wonderful individuals who live with autism every day.” Yet the poisonous headline talking about “significant statistics” — which they were not — was probably enough for most people.

A few days passed, and then came the horrific Santa Barbara massacre, where the killer targeted a sorority in his sick attempt to punish women for rejecting him. Like everyone else, I’ve felt lacerated by Michael Martinez, a victim’s father, and his fiery rage at the vacuum of Congressional leadership, into which so much NRA money has flowed.  As we all try to make sense and even solve this problem, people start thinking about what went wrong. Why didn’t they do anything about this young man’s arsenal of weapons? Why didn’t the parents do more to help? Couldn’t anyone see that this student was very, very sick? Through all of this, there have been questions about diagnosis. Was the young man on the autism spectrum? Or did he have some kind of mental illness? What was it that caused the snap?

Right away there is a rush to explain somehow. The autism advocates divorce violence from the disability. Autism is neurological, not psychological. Autism can have co-occurring disabilities, like intellectual delay or sensory, communicative, or behavioral challenges. But autism does not lead to violence.

There are so many reasons that this tragedy happened, and yet there will be no one answer. That’s something that we humans hate. From the beginning of time we have wanted explanations for why. Why the crops fail. Why we are here. Why children die.

How could this happen? We don’t know. But that is so unsatisfying. What do we do?
Some thoughts:

1) Learn from the killing. Now we know that children and loved ones who seem to have changed for the worse are worth looking into. It is never to early to get help. We also need to monitor them for improvement, or lack thereof. Make sure they are taking their meds, make sure they are not collecting weapons.

2) Advocate for tougher gun laws. Even if later on we find out that this did not work, shouldn’t we give credence to the possibility that more rigorous background checks and limiting certain types of weaponry in the country might help? Perhaps the NRA can meet with Mr. Martinez and then see if they are as certain of themselves. Maybe the NRA can also think about whether the right to live, to not be shot to death, is as important as the right to bear arms? I am not being facetious. I understand the NRA’s insistence on the Second Amendment. I am begging them to be more flexible in the face of growing serial violence from guns.

3) Bolster our access to mental health care. Insurance companies should not make it so tough to get help.

4) Fight the stigma that mental illness — and perhaps autism — carry. Remind ourselves that we cannot turn into lynch mobs informed by our uneducated gut feelings. Keep educating the public that murder is wrong, but mental illness is something that can be helped.

5) Continue to understand all the different forms evil takes. Cultural misogyny is one that we now have to face.

6) Pray for those in pain. Reach out, connect.

 

 

 

 

Friday, May 23, 2014

One Size Does Not Fit All

The institutions are closing. The sheltered workshops are closing. Group homes must be small or else they come under suspicious scrutiny. We don’t want people being clumped together by disability. We don’t want people isolated anymore. Damn right. We want inclusion.

Ah, Inclusion. That beacon on a darkened sea, that oasis in the dessert. The siren song that lures the autism parent onto the rocks.

Hey, I’m all for it. Really. How could I not be? Inclusion is about fairness. Inclusion beckons the outlier into the warmth of the crowd. Soon after Inclusion, there is no more Other, there is just Us.

That’s good, if it can even happen. And usually when people write about inclusion it is to assess how well we do it. Does the school accommodate well enough, adapt curriculum, provide an aide, pull-out lessons, small class-size (any and all)? We also support inclusion in the form of the open door. We now open up the colleges, for example, by offering disability services, or even targeted programs. Legally we must open up the work place and be careful not to discriminate. Lately there is even more focus on vocational training as well as raising awareness in employers. The typical conversation about inclusion is about bringing people in, opening doors that were closed, and reducing isolation.

What is the answer, though, if isolation is good for the person? If the person prefers isolation? Especially in the case of autism: someone with autism might not be able to function well with talkier types, with the mainstream people who are all about including. Someone with autism might not feel understood by normals, by neurotypicals, or even by the larger crowds that inclusive people inhabit.

What if the person wants to live with others like him, where he may feel safer? Don’t we have to take that into account, in the name of Self-Determination?  Or, if we don’t know what he wants because of communication issues, what if the parents or guardians want him with people who have similar challenges, for whatever reason? Maybe it makes staffing more straightforward, for example the house begun in Sharon, Massachusetts that is all Higashi-educated young adults and Higashi-trained staff. This is fine with the Inclusionists, as long as the home is fewer than 6 people. But what if these families want their loved ones to live near others with the same kind of education and worldview?

More than 5 people and you start to have an Institution, and that is frowned upon. I don’t think that’s fair. I think we have to be more individualized in our approach and go with what the person wants — as best as we can. We have to be careful not to be dogmatic and act institutional in the name of a philosophy. Forcing everyone into the same kind of living situation of small group home or even smaller shared living set-up — and refusing to fund anything else — may not be taking into account what the person in question wants.

Furthermore, why do we say that people need “normal” role models? Why isn’t it enough to be with other people, period — even ones as disabled as him? My own autistic adult son Nat loves who he loves. One of his loves is a young man who is really affected by autism. Jumps, pounds his chest, doesn’t talk much, runs around nonstop. Nat smiles alot around this guy, and mentions his name quite a bit. What will Nat ever learn from him, you might ask.

Why is that even a question? You love who you love. Each one of us is a person, a full-on human being. Why is it better for Nat to be around someone who talks? It’s better for Nat’s mental and social development, I know that. But doesn’t this friendship also have merit, particularly in that Nat chooses to be with this guy sometimes?

I venture to say that the same goes for Sheltered Workshops. I don’t like a sheltered workshop when the person can and wants to work outside in a more normal job environment. I don’t believe people should be denied minimum wage. If you’re doing a job, you deserve to be compensated. But I do feel that if you have a really hard time being more out in the world with behavioral pressures and social subtleties and hard ass bosses — maybe you should be able to be sheltered. It’s about the person’s needs, desires, and abilities. Opening the workplaces:  definitely. Assume that every single person should be in the workplace: not so much.

If you think we can close all the workshops and get every single person into a “real” job, then do it. Show me how you can do that for every single person so that no one falls through the cracks. If we can get every single disabled person a “real” job, then great. Do it. If that’s what they want. But I don’t believe that is something that’s for anyone. One size fits all rarely works for something as relatively simple as clothes. One size fits all is pretty much impossible and irrelevant for individuals.

 

 

 

 

 

 

Empathy

Here is my latest column on NPR/WBUR’s Cognoscenti Column, written about 9 year old Benj and how his empathy button got flipped on by a video game character:

It’s easy to associate video games with violence. I used to worry constantly about this connection, especially when my youngest became a dedicated gamer. But even before his affinity with technology began, I worried about his seeming lack of compassion, and how he angered so easily.

Finally we decided to have Ben evaluated at Children’s Hospital. The official diagnosis was, “Normal but stubborn,” which seemed exactly right — but was no help at all. Ben did seem to have a problem with hardheadedness — or perhaps even hardheartedness. My own heart was rubbed raw by this. How could it be that he didn’t get it after all his dad and I did to model empathetic behavior?

But if someone is not ready for a developmental phase, they just aren’t. You can’t hurry love, I guess. Still, I was scared for him; how was he going to get through the vicious years of middle school if he showed so much prickliness and anger so easily?

And indeed, when along came the tween years, we did end up with days upon days of little boys huddled indoors with consoles yelling at blocky figures running up and down the screen. Our house was filled with the breathy flutes of Zelda and the high-pitched screams of Kirby. And then there was the carnival-like music of Super Mario, the plumber-turned-superhero, who moved through pipes trying to catch or escape bad guys, the worst of whom was a character known as the Goomba.

Ben loved the game, and played and discussed it nonstop. I could not tune into the intricacies of the different levels or plots, but I did listen as attentively as a tired and confused mother can. The whole kill-or-be-killed mentality bothered me. But still, Mario seemed benign enough, so I let it go. My mother agreed, and so for Chanukah she presented Ben with a stuffed Goomba. That night, Ben slept with his new toy, which he named “Webster Goomez.”

A day or so later, Ben remarked that Webster was “kind of adorable.”

Adorable? Did I hear that right? Never had such a word come out of Ben before. I quickly recovered my cool and tried not to make too big a deal out of it, so as not to embarrass him. But inside, I cradled that word, longed to hear it again, hoping I hadn’t imagined it. But no, this was for real. A few days later, I heard Ben describing a different character as “cute.”

Had this mean little mushroom cracked open a tiny chink in Ben’s armor? Had the undistilled peevish nature of the Goomba given Ben someone angry to relate to? Maybe it was that loving Webster Goomez didn’t present a threat to Ben’s own tough guy persona. He was free to appreciate his simplistic nasty — but cute — ways.

The Goomba had flipped a switch, and now Ben’s open adoration just kept flowing. The words “adorable” and “cute” became frequent words in his vocabulary. Other evil stuffed characters made their way into Ben’s bed. And, on Ben’s 10th birthday, we felt encouraged enough to get him a game called “Drawn to Life” for his Nintendo DS. Why? Because it too teemed with tiny adorable creatures. Ben showed me the game and how it was played, pointing out these sweet little round blue guys. “You have to step on them, though, you know, to kill them,” he said to me.

“You do?” I asked, dismayed. Why did it always have to end in death?

It turned out Ben agreed. “Yeah,” he said. “It’s too bad. They shouldn’t make them so cute! It’s cruel!”

“Maybe you don’t have to kill them?” I suggested, but halfheartedly, because this was a video game, after all, and even in my day (the days of Ms. Pacman), cute little things had to get eaten or exploded in order to win.

But the next day Ben casually informed me that he was no longer killing the cute blue guys. He had also told his friend not to kill them.

“Wow!” I said, a fullness in my heart, so much pride at this new moral strength. “So, Ben, what will happen, do you think, if everyone stopped killing those blue guys?”

“They’d get to live!” he shouted happily.

Game over?

Friday, May 16, 2014

What, Exactly, Is Normal?

I just now drove down into the busy part of town and while I was stopped at a light I saw a man standing alone, smiling. I looked back at the red light and then quickly back again at the man. Sure enough, he was smiling still, the same full-on toothy genuine kind. I gave him another nanosecond, glanced again. Yep, still. I concluded that he was autistic. To back up my conclusion: he was swinging his body slightly. He tilted his head back, and the sudden breeze touched his hair as it breathed through the leaves overhead. He rolled his head downwards, still smiling.

A velvety pain spread through my chest, but I wasn’t sad. The closest I can come to naming this was a kind of exquisite tenderness, a protective small love, almost. Stay happy, Autistic Man. Sweet soul.

The light changed and I moved slowly, back to the small sharp sparks of driving in traffic. I thought about the man, and how purely joyful he seemed and then I wondered with a tinny pang if I was being patronizing. I know that I’m at least bumping right up against that line, assuming anything at all about him. But I don’t think so. If a broad continuous smile and enjoyment of a breeze doesn’t mean happiness I don’t know what is. Am I to assume that just because he’s autistic — and of course there’s the possibility he is not — that the smile could be anything? A sensory grimace? A meaningless arrangement of facial muscles upward? No. We humans have the power of observation mixed with intelligence and experience, and so we get to draw certain conclusions.

His easy happiness made me think about his difference. He — along with so many others who have developmental disabilities — just did what he wanted. Which is exactly what is “wrong” with him. In our society, normal means subtlety. Normal means taking an average of the population’s actions and expressions and going with that, rather than the astounding burst of unique feeling you may have inside. This guy was letting his insides show. Even though his inner joy was harmless and probably innocent, it is still socially incorrect to show it, unless the social average does that. No harm done, of course, in this case people were just walking on by. Good that they weren’t being pills about him; bad that they weren’t touched by him.

I got to thinking about how people sometimes assume that those with Down Syndrome, for example, are happier than most, and that that is the special gift they give us. “I don’t know, they just seem to love people more, they just see the goodness in them,” is what some might think. But I don’t agree with this assumption, however, because we don’t know if a given person is happier than we are. But I do think that we can look at another person and conclude that he is showing his happiness more blatantly than most.

To me, it is that ease the autistic man had with his happiness that was the gift. It was the fact that he may not have even known that you’re supposed to reign it in a little or risk judgement.  Or he was simply unable to act any different. Or that he was consciously acting different. Any one of those possibilities is a gift to me because I have a real difficulty sliding into my most natural self. I am hyper-aware of others, it’s how I was raised. I may seem to be ultra compassionate and perhaps socially sophisticated, and okay I probably am. But one thing I can’t do very well is just stand there grinning my head off in front of a bunch of strangers. If I enjoy a breeze, I am conscious of enjoying the breeze and that it is, in that instance, okay to shut my eyes and smile. Maybe laugh briefly. But it has to end soon, or I’m a little weird.

(It’s only on my bike or with Ned that I’m the most me, where I can just laugh or sing without thinking.)

The way this man stirred my heart and made me think, and feel, in an otherwise ordinary boring crawl through traffic is special. I hope he never learns to be any other way.

 

 

Tuesday, May 13, 2014

Poem for the IM Age

I came downstairs and found ur note

(on instant message, of course)

It was just I love you

Just and all

When you’re really there

Even just

lower case

In bits

I rise out of my words

to my surface

to meet you.

 

 

Saturday, May 10, 2014

PBS World’s Airing of “Rachel Is”

Here is the link to the 90 minute PBS World show “America Reframed,” which aired the documentary Rachel Is last Tuesday night, May 6, 1014. Rachel is an intellecutally disabled 21-year-old about to graduate from school. She and her mother are working very hard to find her independence in the form of housing, but it is a struggle. The relationship between Rachel and her mom often are severely strained, which is what makes this film worth watching — the honesty in filmmaker Charlotte Glynn’s style makes you stop breathing sometimes, cringe other times, and always cheer for the family. After the documentary (60 mins long) there is a conversation between NY Times Reporter Amy Harmon and me, with the host Natasha Del Toro. Take a look; the link will only be good until August! Enjoy.

Monday, May 5, 2014

Watch Me on PBS 5/6/14!

On May 6, the PBS show “America ReFramed” will be airing the new and unusual documentary “Rachel Is,” about a young woman with an intellectual disability and her last year of school. Rachel and her mom try to find a good living situation for Rachel — outside of her mother’s house. Rachel’s sister Charlotte Glynn filmed this honest and sometimes uncomfortable doucmentary.

Pulitzer-prize winning journalist Amy Harmon and I are the panelists who will discuss the documentary and issues around autism, after the film (this is the America ReFramed format). Natasha Del Toro hosts. Check your local PBS listings for specific time in your area.

Nat Receives 2014 Worker of the Year Award

Nat won the 2014 Worker of the Year Award from Autism Services Association in Wellesley, MA. Here is what Dr. Joel Smith, Executive Director of ASA said about Nat:

The 2014 Worker of the Year is someone who started at ASA in 2012, and immediately applied for a job, for which he just celebrated his 2 year anniversary, at a large supermarket chain. While that job is 3 days a week, this person also enjoys volunteering his time on his days off delivering hot meals to appreciative elders in the community. That commitment just reiterates how strong his worth ethic and drive is.

This Worker of the Year is someone who brings that same commitment to his leisure activities, whether it be his love of swimming in the pool or knocking down the pins while bowling. He is well-liked by his peers, and is always willing to lend an extra hand in helping others.

So it is our honor to announce that the 2014 Worker of the Year is…Nathaniel Batchelder!

 

2014-05-05 13.35.07

GO NAT!!!

 

Friday, May 2, 2014

A Resource and An Initiative for ASD Adulthood

There are two new developments in quality of life offerings for people with intellectual disabilities and those on the autism spectrum as well, that I wanted to share. The first is a website and the second is an initiative.

1) “Interacting with Autism:” A Wealth of Information

The website is Interacting with Autism. Here is how they summarize their resource. The very last sentence of this paragraph is what drew my attention in particular, but read it all and click on the link, please!

 The site presents the most current, evidence-based treatment information to parents, educators, health care workers, and those on the spectrum.  It was developed collaboratively by Academy award-winning filmmaker Mark Jonathan Harris, USC university professor Marsha Kinder, and multimedia designer Scott Mahoy, working with the nation’s leading autism experts as consultants.  Based on an exhaustive review of the last decade’s scientific and treatment research, it uses case histories, animation, and documentary vignettes to provide information about autism and insight into how different families cope with it. You may have seen our Sensory Overload video, which was featured on everything from NPR to Andrew Sullivan’s The Dish.   The site’s unique format provides a dynamic environment for exploration, more so than a typical text-based, didactic site. It also presents a searchable video database with over 10 hours of interviews and a section showing how autism is being represented in popular culture.  The 30 full-screen videos examine a range of topics, including causes, diagnosis, treatment, education and advocacy and present a variety of perspectives–people on the spectrum, parents, and leading researchers and therapists in the field.   It welcomes comments and discussion, and allows for users to post videos.  Information on local insurance, Medicaid and educational resources are also linked through an interactive map.

 

2) Higher Education for People Post 22 with Intellectual Disabilities and Autism

The second news is an initiative about to begin in Massachusetts. A few months ago Massachusetts’ Chair of Higher Education Committee in the State House (Representative Tom Sannicandro) put together a Task Force on Higher Education for Students with Intellectual Disabilities and Autism Spectrum Disorder.  The Task Force consisted of educators, administrators from colleges around the state of Massachusetts, advocates, government agency officials, and two parents — I was one of them. Here is an abstract from the final recommendations, which can be found here.

Findings & Recommendations

The Task Force sought ways to expand opportunities for students 18-22 as well as students older than 22 with intellectual disabilities and autism spectrum disorder. The Task Force recorded seven findings from the hearing and made 15 recommendations based on those findings. Some of those findings and recommendations include the following:

Finding 1: Higher education is an important pathway to employment in the community

Recommendation 1a: The Executive Office of Education (EOE), in consultation with the Department of Higher Education (DHE), the Department of Elementary and Secondary Education (DESE), and the Executive Office of Health and Human Services (EOHHS) shall develop strategies and procedures to assist students in accessing inclusive higher education, integrated competitive employment, and independent living opportunities.

Finding 2: Students with ID/ASD ages 18-22 experience barriers in their transition from high school to adult life, including lack of access to Inclusive Concurrent Enrollment opportunities. MCAS requirements bar many students. Students with ID/ASD who reach the age of 22 have even more limited access to inclusive higher education because they are not able to participate in Inclusive Concurrent Enrollment opportunities after they turn 22.

Recommendation 2a:  Allow students who have not passed MCAS to enroll in inclusive credit and non-credit courses. Prioritize enactment of H.1080, An Act Securing Access to Higher Education for People with Disabilities.  (Rep, Tom Sannicandro has filed portions of H. 1088 as Amendment No. 692 to the House budget set to begin debate on Monday April 28.)

Recommendation 2b: Expand the Inclusive Concurrent Enrollment initiative for students with ID/ASD throughout the state, with full participation of the Commonwealth’s 29 public institutions of higher education by 2019.

Finding 3: Students with ID/ASD must attend an approved Comprehensive Transition Program (CTP) in order to be eligible for federal financial aid (i.e., Pell Grants, Federal Work Study Program, and Supplemental Educational Opportunity Grants).  Massachusetts currently does not have any approved CTPs.

Recommendations 3a:  EOE, in consultation with DHE and DESE, shall create training materials instructing state institutes of higher education and providing technical assistance on how to apply to become an approved CTP so that students with ID/ASD who have exited high school are eligible for Federal financial aid.

Finding 4: Initial data reported by DESE demonstrate the value of the ICE initiative. To date, resources have not been available to conduct a more comprehensive evaluation in order to further identify student outcomes and evidence-based practice, including practices, policies, and structures that are correlated with improved student outcomes in areas such as integrated competitive employment, self-determination, independent living, and community membership.

Recommendation 4a: Allocate funds for comprehensive evaluation and research of the ICE initiative.

 

Thursday, May 1, 2014

Sports is the Catalyst

I was interviewed by Nick Savarese of Special Olympics Massachusetts, for their podcast: “Sports is the Catalyst.” You can listen to it here.