On Absurdly Poor Criticism And Advocate Misconduct, Part One

On September 14, 2013, exactly a month before I started writing this post, I was contacted by a colleague who expressed an interest in changes in behavioral practice since Lovaas's original methods and models of clinical treatment.

During the resulting exchange, I attempted to explain a variety of things related to behavior analysis, ranging from how ABA is not a treatment method to the relationship between ABA and PBS (the short version is that PBS is a brand-named philosophy regarding how to go about conducting and using ABA research). I also provided her with a number of assorted articles and writings on the subject, including a piece of my own work which acted as an overview.

I ended the exchange on something of a positive note, hoping that the information would help. The positive note, however, did not last.

This is what she wrote... or, at least, the currently-published version. There has been a rather spectacularly intellectually dishonest edit in the interim. It's, to put it mildly, an extraordinarily poor critique. The arguments are, by and large, spectacularly off-base, and her abuse of my writing is glaringly obvious (if not as much so as before the edits).

That said, I should probably discuss what this means and why it's a problem before I get into a detailed critique of the piece itself.

Contrary to what some people apparently believe, saying that a critique is poor does not mean that one disagrees with its conclusions or that the critique does not deal with real problems. It is saying that the critique misidentifies the issues involved and/or argues from a position of misunderstanding or prejudice.

In this case, the author is attempting to argue that all forms of applied behavior analysis are inherently unethical -- a very, very strong conclusion, one that simply does not follow from the evidence (such as it is) and arguments (such as they are) that she presents. Saying so isn't defending ABA, and certainly isn't excusing, justifying, or apologizing for the assorted abuses with which people have valid complaints.

This is important for several reasons -- not the least of which is that poor criticism serves to distract from real issues, detracts from good criticism, and confuses issues in ways that impair efforts to reform things.

To illustrate this, let's take a very different example, one that most of us can rapidly identify, easily understand, and generally make easy sense of: one of the more disgusting things which occurs whenever news story publishes a story about a black man raping a white woman.

Rape is obviously wrong: it's a gross violation of  a woman's bodily autonomy, a dehumanizing act which can easily (and often does) destroy her life. It is very difficult to think of a worse violation of someone's personhood... and the ethnicity and skin color of perpetrator and/or victim is utterly irrelevant to this.

Unfortunately, however, some people insist on making the moral issue here about race in a variety of ways. One of the simpler (and more vile) of these is to simply state that the act was wrong because a man like that (a black man, not a rapist) has no business sexually touching a White woman.

This is an absurdly poor (and racist) criticism of rape. It is one that needs -- urgently -- to be shouted down and combated whenever it pops up.

Referring to this sort of thing as poor discussion or off-base criticism is very much not excusing the heinous criminal act to which the alleged criticism was directed. It is simple truth.

The race thing serves to distract from the real problem. To the extent to which it gets attention, it's distracting people from paying that same attention to other, more relevant, criticisms.

But... let's say that some people actually took it seriously. Let's further say that they then tried to use it as the basis for political reform efforts.

These efforts would be useless at best and harmful at worst. In fact, that particular criticism can pretty much be considered a form of rape apology in and of itself: if the rape of a white woman by a black man is only heinous because of the race difference, what's wrong about a white man raping a white woman?

More, such "reform" efforts would likely target and harm completely innocent interracial couples. In fact, such prejudices and acts have historically caused very substantial harm in the form of blatantly racist legislation and various racial prejudices for just this reason.

Obviously, this has little directly to do with the ABA article which started this discussion, but does serve to illustrate a few very important points: 1) poor criticism is rarely helpful; 2) poor criticism is often harmful, even when its conclusions may be correct... and 3) stating that an argument is poor is not the same thing as stating that its conclusion is wrong.

In Part Two of this series, I will hopefully get to precisely why the specific critique that started this is poor and unlikely to be helpful. In Part Three, I will discuss just why I'm taking such pains to lay out these problems, why a simple blog post like that has lead to me starting an extended blog-rant, just what followed from the situation, and why it's taken me so long to post all of this.

On Bad Parents

Today is Autistics Speaking Day. To follow in the tradition of last year, I'm going to take the opportunity to talk about something that I wouldn't normally blog about. Be forewarned that this is not -- at all -- a pleasant topic. In fact, it's downright disturbing. If you are a parent to an autistic child, this will be particularly disturbing to you. If you are autistic yourself, it will be equally disturbing in a completely different way. Be forewarned.

Towards the end of September, the blog The Thinking Person's Guide to Autism hosted a series of exchanges referred to on-site as the Self-Advocate/Parent Dialogues. If you haven't read it, I strongly recommend you do so -- including the comments. Yes, I know that's ten-eleven (depending on how you count) blog entries, many of which have an inordinate number of comments. I make this recommendation anyway -- and recommend it strongly.

During that exchange, a lot of issues -- many of which are very important -- relating to the parent/self-advocate divide in the modern autism world were discussed. By and large, the parents present were interested in helping their child and were willing to respect and try to understand the viewpoints and interests of autistic people. And, while I can't directly confirm this, I strongly suspect (and have no reason to disbelieve) that those parents love their children and wanted to do what they could to help them. I believe (and have no reason to disbelieve) that, to those parents, their involvement in autism issues was not primarily about themselves or their personal interests and desires, but rather about trying to raise their children.

One fact, however, was not mentioned during that dialogue, and it's a simple fact that while the above can almost certainly be said about the parents who participated in the Dialogues, it certainly cannot be said about all parents. Put another way, not every parent of an autistic child is a good parent.

"Good" and "bad" are relative, of course, and everyone makes mistakes. I'm not trying to demonize or stereotype the parents of autistic children here.

Still, there's an attitude among parents' groups characterized by the presumption that each parent loves their child and is generally trying to raise their child as best they can. There are three real problems with this -- and I've already discussed the first one. Specifically, parents are human and thus fallible. Even if a parent is trying to raise their child as best they can, this doesn't mean that they are.

The second problem with that presumption is far simpler. It simply isn't true.

I know I've repeated myself here. This was deliberate. The point needs to be driven in -- preferably with a metaphorical sledgehammer.

For years, I've been reading coverage of parents doing truly awful things to their children. Take for instance, Marguerite Famolare, as quoted in this article about the Judge Rotenberg Center. According to her, the center's systematic torture of her child is great -- after all, if she shows him the remote control to his shock harness:

He'll automatically comply to whatever my signal command may be, whether it is 'Put on your seatbelt,' or 'Hand me that apple,' or 'Sit appropriately and eat your food,'" she says. "It's made him a human being, a civilized human being.

I have to rather strongly disagree with her definition of humanity. Beyond this, I think that the quote speaks for itself.

Then there's the case of Karen McCarron, who I recently learned is trying to appeal her well-deserved sentence and get a new trial. Her story is, in a way, much simpler to explain -- she murdered her daughter and blamed her actions on said child's reified neurology. According to her lawyer, McCarron believed that Jesus would bring her child back, sans certain reified aspects of how she learned and experienced the world.

I did not select these two cases at random. While I could have picked from a lot more, including many not on that list (which is rather outdated at this point), they serve as illustrations of the fact that there are some phenomenally bad parents out there. Some of said parents have autistic children.

More importantly, however, they serve to illustrate another factor -- the ways in which certain attitudes prevalent in the autism world can be used as justifications for truly monstrous acts towards autistic people. When I object to, for instance, the reification of autism, I am doing so for damned good reason. When I talk about psychosocial stigma, I am not talking about something even remotely close to trivial.

Finally, these cases are public -- they have public documentation which I can link to. Trust me, I have a lot of examples from personal experience. I've spent a surprisingly large amount of my professional life trying to clean up the messes that bad parents and poor parenting decisions (of various sorts) have left behind.

The third problem with the attitude I referenced is central to the attitude itself and not the underlying beliefs. There is an old saying that "sympathy for the guilty is treason to the innocent." The saying -- and the underlying meaning behind it -- apply here. Yes, parents of autistic children often function without adequate support, are stressed, are under incredible pressures, etc. If, however, we choose to allow this to detract even one iota from our condemnation of this sort of parent's inexcusable actions, if we say that Karen McCaron's actions were "really about a lack of support" or some such, we are essentially arguing that the act of torturing or murdering an innocent child is excusable.

I disagree with this in the strongest terms possible.

Such actions need to be condemned. We, as a community, owe that duty to Karen McCaron's and Marguerite Famolare's victims.

I have, at this point, been writing this blog entry all day -- essentially dropping everything else in my life to do so. It is, however, phenomenally difficult for me to do so. As I type this sentence, it is 6:17 in the evening. I have been writing this almost since I finished breakfast.

As the amount of time I've spent on this text implies, this is not an easy topic for me to write about. I don't even like to think about parents such as those two. I originally intended to write far more about them than I did... but gave up on several (actually rather important) points simply because I couldn't bring myself to write them. In fact, I even dropped one major and prominent example of bad parenting from my list -- simply because I didn't think I could stand writing out another paragraph detailing such behavior. I know for a fact that I will regret that decision.

I would love to think that every parent was a good one, that (all) parents could be trusted to act in their child's best interests, and that we could count on parental love to ensure that our parents would be our allies.

Unfortunately, I know all too well that this is simply not true.

On Diagnosis

In most of medicine, the term "diagnosis" refers to the process by which a doctor (ideally) determines what disease process is underlying a patient's symptoms, as well as the determination itself. To clarify the relationship between the two meanings: diagnosis is the process by which the doctor provides the patient with a diagnosis.

Because diseases are abstractions based on cause (or "etiology" in medical language), a diagnosis serves as an explanation of the symptoms involved. This might sound rather sophisticated and/or complicated, but it's really not. If you go to the doctor's office and complain that your stomach hurts, "indigestion" is an explanation because it refers to a causal process (that is, why your stomach hurts). Were the doctor to use an abstraction based on symptomology (such as "stomachache"), it would not.

Of course, the doctor's explanation for the symptoms can be wrong. Throughout most of medicine, this is referred to as "misdiagnosis". There are also syndromes and the like which we don't know the causes of and times when the doctor can't figure out what's going on. While we know some things about these syndromes and cases (e.g. epilepsy tends to be chronic problem), these "diagnoses" aren't explanations of the symptoms -- they're descriptions of them.

Once you get it, this is really pretty simple. An answer to the question of why your symptoms exist (in more technical language, an "etiological construct") can explain them; a description of the symptoms themselves (in more technical language, a "symptomolgoical construct") can't. Despite this, however, people often make this mistake in a wide variety of ways. There's even a formal name for doing so: "nominal fallacy".

Put yet another way, you cannot say that your stomach hurts because you have a stomachache. "Stomachache" is a symptomological construct -- a label for the stomach pain. You cannot say that you are having difficulty sleeping because you have insomnia. The statement that you "have insomnia" is simply another way of saying that you have trouble sleeping. Neither serves as an explanation. This isn't to say that terms and concepts like "stomachache" or "insomnia" can't be useful, but they can't answer most questions of "why"... because they have nothing whatsoever to do with cause.

I'm making this as clear as possible because there is one field of medicine where the definition of the term "diagnosis" I provided does not apply. That field is psychiatry.

"Mental disorders", as used in psychiatry, are not etiological constructs. They are symptomological constructs. To use my earlier analogy, they are not akin to "indigestion" and are more akin to "stomachache". When a psychiatrist "diagnoses" a mental disorder, they are emphatically not saying anything about the cause of the symptoms you present them with -- they are simply deciding how to describe those symptoms in the standardized and highly formalized language of psychiatry.

The psychiatric "diagnosis" of "major depressive disorder" is simply another way of saying that someone is depressed... only it's far more precise (among other things, it distinguishes "major depression" from less severe or more transient types of depression). The psychiatric "diagnosis" of "bipolar disorder" basically means that someone goes through 'episodes' during which his mood is different from normal (in a clinically significant way). Similarly, the psychiatric "diagnosis" of "autism" basically means that someone isn't following the developmental psychologists' often-bigoted (and why I call it that is a whole 'nother blog post) One True Developmental Path for human beings.

When looked at this way, the way that people tend to accumulate multiple psychiatric diagnoses is easily understood -- for many of the same reasons that I don't think people would be surprised to learn that people with stomachaches also have fevers much more frequently than people who do not. This is simply because fevers and stomachaches can be caused by many of the same things.

This does not, however, mean that "fever" and "stomachache" are the same thing. It also doesn't mean that it's appropriate to treat all people with stomachaches as if they also had fevers.

Moreover, the evaluation of "symptoms" in psychiatry is far more subjective and problematic than it is anywhere else in medicine. The problems with this are anything but simple, even if they're frequently ignored.

The easiest of these to resolve are simply matters of degree -- for instance, what constitutes "markedly diminished interest or pleasure in... activities"? Where do you draw the line between what's "markedly" diminished and what's just diminished?

For the most part, these represent a sort of diagnostic "fuzziness" which is... resolvable, albeit not necessarily easily. Statistical methods are pretty good at dealing with this sort of issue in a research setting, although the problem remains. It remains an obstacle, but hardly an intractable one. If this problem is not understood, however, it can create a very wide variety of misconceptions.

Other problems, however, are more noteworthy -- and fundamental. For one thing, the defining feature of a "symptom" in medicine is that it's viewed as an indicator of an underlying pathology. Stomachache is a symptom of indigestion because it provides evidence in support of the idea that you are having trouble digesting food. It provides this evidence because problems with digestion tend to cause stomachaches. "Stomachache", in general, is viewed as a symptom of disease because a stomachache is a pretty clear indicator that something is going wrong in the body (even if you don't know what, and even if the problem is fairly minor).

In other words, a "mental disorder" is a disorder because it is viewed as a sign that there is something wrong with the person who exhibits it. Our judgments of what constitutes something being "wrong" with someone, however, are notoriously problematic.

We human beings have a tendency to judge other people based on our expectations and our often-prejudiced personal (and/or cultural) views on what people should be. When people fail to live up to these, we tend to conclude that there's something wrong with them, rather than concluding that the problem was with our views and expectations.

For instance, homosexuality used to be a DSM mental disorder (and even though most sources will state that it was removed in 1973, this is not entirely accurate). Moreover, its official status as such has a long history of being used to justify the torture (via abusive "treatments") both of homosexuals and people judged as being "at risk for" homosexuality.

Then there's the rather infamous (and atrocious) example of the countless ways in which psychiatry and psychiatric diagnoses have been used as a tool of institutionalized racism and of racial oppression. We can even look at the ways in which attitudes about race have affected diagnostic patterns.

Then there's the issue of so-called "diagnostic redefinition", something which is rather hard to understand for people who don't understand that psychiatric disorders are symptomological constructs.

Diagnostic redefinition is relatively easy to understand if you look at approximate analogues involving symptomological constructs in the world of general medical practice. In this case, I'm going to use the construct of obesity for the purpose of explanation.

At present, obesity is most commonly defined in terms of something called "body mass index" (BMI) -- a calculated value based on height and weight. Neither BMI nor obesity, however, are etiological constructs -- they're descriptive constructs. In the case of obesity, it's a symptomological construct, presently defined by a BMI of thirty or higher (in most countries, anyway).

If, however, medical researchers were to find that a different cutoff point -- say twenty-five (which, incidentally, is the cutoff point in Japan) or thirty-five -- was more meaningful, the cutoff point would change to reflect this. If the cutoff point was lowered, a number of people would suddenly find themselves "obese" when they weren't before -- something which is called "broadening criteria" for obesity. If the cutoff point was raised, a number of people would find themselves no longer considered "obese", due to something called "narrowing criteria".

Note that nothing would really have changed with these people themselves. Only the terms used to describe them -- the label they receive, in other words -- would have changed. This is the essence of diagnostic redefinition in psychiatry.

Despite this, however, it's often nowhere near so simple -- especially when it comes to the DSM. It's quite common for criteria to broaden and narrow at the same time. This usually happens when rather than changing a numeric score to broaden or narrow criteria, the metric is changed or redefined.

To continue the analogy, if we were to find that some other measure of obeisity (e.g. total body weight, percentage body fat) was more meaningful than BMI, our definition of obeisity would shift to accomodate this. Obeisity would be redefined in terms of this new metric, and a number of people would suddenly "gain" or "lose" a "diagnosis" of obeisity without changing one whit themselves. The newly "diagnosed" or "undiagnosed" wouldn't have changed -- the language used to describe them would have.

This is precisely what happens every time a new edition of the DSM comes out. Sometimes it happens more often.

Note that none of this means that the "diagnosis" of "obesity" isn't useful or meaningful. None of it means that obesity isn't real (although if one is feeling particularly philosophical, one can point out that it's only a label or descriptor, and as such the phrase "for a certain value of 'real'" applies -- it's only "real" in the sense that "redness" is; similarly, "autism" is only real in the senses that "intelligence" is).

There are countless other problems with psychiatric diagnosis. Quite frankly, I'd write about them more, but this entry has been sitting half-completed for more than long enough already.

I just hope that this helps people understand certain matters and helps clear up some of the assorted confusion regarding the topic. Countless authors -- in academia, in the blogosphere, in the print media -- clearly don't understand a lot of what I try to explain above.

Hopefully, I did not just "try".

An Open Letter to Buzz Aldrin

Today is Autistics Speaking Day. For those of you who are unfamiliar with the event, it's an autistic reaction to the highly-misguided "Communication Shutdown Day", a day in which we autistic people make as much online "noise" as possible... on the day in which hordes of people are voluntarily abstaining from our preferred means of communication.

I won't discuss why the whole idea is a bad one. Others have already done so -- far better than I ever could. Instead, I'm going to post an open letter to one of the major participants in this farce.

Dear Mr. Aldrin,

When I was a child, the Apollo missions were a great inspiration to me. They truly stand out among the achievements of mankind as a spectacular triumph of science and a shining example of what man is capable of if we truly try. You, along with the other Apollo astronauts, were my childhood heroes. Your triumphs fanned the flames of my love of science, helping raise it from the bare embers of a childhood interest into a lifelong passion. Your successes comforted me when things seemed hopeless, helping to reassure me that even the seemingly impossible was often within reach.

Today, I am a graduate student in Nova Southeastern University's M.S. Counseling program and working towards board certification as a behavior analyst. My dream is to go into psychological research and to help raise the standards of the discipline to the point where psychology and the other "soft" sciences can be legitimately compared to the "hard" sciences in terms of methodological rigor... and to come, bit by bit, closer to the countless truths I seek. This is not to say, however, that I do not face substantial challenges in reaching my goal.

The worst of these challenges are prejudice and fear. You see, I have a disability. One of my professors flat-out told me (in writing, no less) that having it was unprofessional... in a course where a third of the course grade was participation and professionalism. My clinical ethics textbook states that I am not human. Fear-driven efforts to create a world without people like me in it have already claimed countless lives throughout the world, including at least ten innocent babies in California... this year alone. There's even a clinic within easy driving distance of my house dedicated to chemically castrating people like me.

My disability is most commonly called "autism".

This is why it hurt me so incredibly much to hear that you, one of my childhood heroes, has been raising money for a fear-mongering antivaccine group dedicated to the goals I mention above. I can only hope that you did this out of ignorance; the thought of you having done so knowingly just hurts far too much.

As you may or may not know, the proceeds from Communication Shutout Day go to the program's "global partners". In America (outside Colorado), this means Giant Steps, the Hollyrod Foundation, and the National Autism Association. It's this last which is the most concerning.

The National Autism Association is an anti-vaccine group dedicated to promoting untested, unproven, and often dangerous "treatments" for autism. They praise intravenous chelation (which risks death and brain damage, and, more importantly, involves pumping an irritant into a child's veins for at least two hours at a time). Their 2009 conference, which was held within walking distance of my house, featured a keynote presentation by Andrew Wakefield (whose unethical conduct and Mengele-like "experiments" were largely responsible for major measles outbreaks throughout Europe), a presentation blaming my neurology on MSG in vaccines, and a presentation on why my neurology should be considered a disease (among countless other things). One of their past conferences even involved a keynote from an infamous quack who makes his living chemically castrating autistic children (and who is responsible for the clinic near my home). They recently were involved in a concentrated effort to effect legislation here in Florida which would have effectively banned the flu vaccine. I am perfectly willing to provide references and further information on any of these assertions on request.

Mr. Aldrin, you are old enough to remember many of the diseases which vaccines prevent. For instance, with polio alone... the iron lungs, the countless children who were crippled for life... to groups such as the NAA, bringing back these things is worth it if it means not having people like me or my friends around. You should also remember Jonas Salk and his heroic dedication to the welfare of the children of the world. To groups such as the NAA, Jonas Salk and countless others like him are villains. I find it difficult to express the sheer perversity of this.

I will admit that the NAA has also campaigned against the more "classic" abuse of children with disabilities in the forms of seclusion and restraint. This, however, mainly serves to help legitimatize them and to help them lend support to other, wackier anti-vaccine organizations such as Generation Rescue, SafeMinds, and the National Vaccine Information Center. In a recent conference presentation on the NAA, I referred to them as a "gateway organization" because of their function in such groups' recruitment tactics.

I won't pretend that this is the only thing wrong with Communication Shutout Day. I strongly encourage you to read what Ari Ne'eman of the Autistic Self-Advocacy Network has written about the matter ( http://www.autisticadvocacy.org/modules/smartsection/item.php?itemid=122 ) and to peruse the various online writings relating to Autistics Speaking Day and the reasons for it.

In the meantime, however, I have to go to bed tonight knowing that one of my childhood heroes has chosen to raise funds for a group whose dedication to creating a world without people like me in it is so strong that they are perfectly willing to sacrifice the lives of countless innocents to create it.

Sincerely,

Alexander Cheezem

The Bigotry Defense?

Some of you may be familiar with the Alex Barton/Wendy Portillo case. For those of you who aren't, it started two years ago, when a kindergarten teacher (Portillo) had her class list off why they didn't like an autistic classmate (Alex Barton) and then had them vote him out of her class. To briefly summarize a really, really long story, Alex is now doing quite well academically in a different school district (although he still bears emotional scars), Wendy Portillo is back in the classroom (retaining her tenure) and again abusing students, and Alex's mom, Melissa, has filed a federal lawsuit against the Portillo and the St. Lucie County school district.

I'm writing this blog entry about that last one. You see, the school district's defense is apparently going to be something along the lines of the argument that the incident didn't hurt Alex... because autistic children can't understand -- or be hurt by -- "negative social feedback" (or, in other words, someone else doing something nasty to them).

No, I'm not joking.

After going through quite a bit of trouble, I've managed to obtain some of the documents that the district's submitted in their defense. Specifically, I've obtained the "expert testimony" that they commissioned from two doctors: Dr. Sue Antell and Dr. Max Wiznitzer.

These are quotes from public documents available on PACER, albeit not for free. I had to jump through a lot of hoops to get them (although, admittedly, most of these were technical -- I didn't bring a memory card with me when I went to visit my school's law library, the law library's one computer set up for PACER access was an antiquated technical nightmare, and I didn't want to unnecessarily spend money to get the documents from my home system), but they're still technically public domain. As such, I've uploaded them to RapidShare to cut down on the metaphorical red tape. Feel free to host them elsewhere.

I'm not going to comment over-much on them. I'm going to let what they wrote speak for themselves. I will, however, clarify a bit on both.

To start off with, there's this section of Dr. Antell's testimony -- delivered before she ever met or examined Alex (whose full name is Caleb Alex Barton, although he does not respond to "Caleb"):

... Based upon this review, it is my opinion that CAB probably does have Autism, a disorder of language, executive functioning and social relatedness, which profoundly impacts upon how a child perceives and reacts to the language and behavior of other people.

It is further my opinion that the events described would not be expected to have any long term impact even upon a typical child who might appreciate more of what was going on around him. As they grow up, children experience numerous negative or unpleasant experiences with peers, teachers and parents. Such experiences are part of the normal experience of development. They serve to help a child develop an appreciation for the impact of his behavior on others in his world, and are important in the development of sympathy, empathy, and altruism. This is quite different from the constant and chronic bullying which we unfortunately see somewhat among older children, or the chronic systematic emotional abuse of a child by the adults in his life. In any child with Autism, such experiences are going to be processed quite differently. Depending on the extent of the pragmatic language dysfunction, the lack of social relatedness, and the impairment in the ability to appreciate another's point of view (what psychologists call "Theory of Mind") it is quite likely that many, if not most children with autism would simply have no emotional connection to such events. While they might encode and recall the "script" (i.e. the language used and the actual events), their ability to be emotionally impacted by what is almost entirely a language based experience would be anticipated to be exceedingly limited. This is not to imply that Autistic children cannot experience trauma. Rather it attempts to distinguish between possibly unpleasant events which are the result of linguistic exchanges from more primitive responses which might involve non verbal actions, or verbal communications which would produce feelings of fear or terror which are generated by non cortical brain regions.

Beyond this, we have the opinion of a qualified child psychiatrist that CAB suffered no emotional distress as a result of this incident, and another who described behavior with autism but not PTSD.

Based on the foregoing, it is my opinion to a reasonable degree of neuropsychological probability that CAB has not demonstrated any real evidence of emotional distress as a consequence of the events of 5-21-08. It is further my impression that he does not require any ongoing treatment, and depending on his ability to appreciate what is happening in such therapy, that this poses a risk of creating a trauma where none actually exists.

Two clarifications: "The events described" were the vote-out incident. The same is true of "the events of 5-21-08".

And then there's Wiznitzer's testimony:

In summary, Caleb Barton is an 8 year old boy with a diagnosis of an autism spectrum disorder (Asperger disorder) and behavioral features labeled as attention deficit hyperactivity disorder (including compatible rating scales). He has a history of challenging behaviors in kindergarten with no details of his behavioral functioning since that time (except for the report of Dr. Coleman). School records document impairment in social interaction with peers (supported by psychiatric evaluations). Assuming that his diagnoses are accurate, it would be difficult for a child with a significant impairment in socialization (compounded by the social issues associated with ADHD) to fully process and comprehend the impact of negative social feedback from peers (as stated by Dr. LoSardo "on some level he probably didn't get social significance"). Therefore, this type of event would not be expected to result in PTSD.

Dr. Wiznitzer's testimony is nowhere near as bad as Dr. Antell's... but really.

To the St. Lucie County school board, however, I have only one thing to say.

On Stereotypes

One of the kindest, most generous people I know is a homosexual, atheistic skeptic. I mention this not because I'm an atheist (I'm not, certain people's claims to the contrary aside) nor because I'm gay (I'm not), nor because I'm a skeptic (this, at least, I am). I mention this because "kind" and "generous" are very much not part of the stereotypes surrounding atheists, homosexuals, or skeptics.

Despite the stereotypes, however, he is all of these things. In fact, the entire list of traits works together quite well: his skepticism, for instance, means that he investigates charities before he gives to them and tries to make sure that his donations actually go to the people he's supposed to be helping. He's skeptical about the charities he donates to precisely because he genuinely cares. I cannot say the same for many people who donate to religious charities, who often care more about appearances or ideology than genuinely helping.

The prevalent stereotypes, however, would pidgeonhole him as the exact opposite of who he is: atheists are often seen as prototypical sinners, untrustworthy and criminal. Skeptics are seen as cynics at best (true skeptics are anything but). Homosexuals... let's not even go there.

Many of the people who know me will know precisely who I am talking about. There is even a possibility that the person I wrote about will read this blog entry some day. I am not, however, writing this to flatter him.

I am writing this to illustrate the point that stereotypes are often misleading. Worse, they are often wrong -- that is, they very often don't even have a genuine basis in fact, but rather are based solely on prejudice or incomprehension.

If this is the case, why do we persist in stereotyping? Especially now, as we're becoming increasingly aware of the manifold harms and errors perpetuated by this sort of thing -- why do it?

The sad truth of the matter is that, as best we can figure it out, stereotyping is the result of normal, adaptive cognitive mechanisms being used in ways that just don't make sense. People, in general, categorize other people in ways that just don't make sense... and then use these categories to reach conclusions that make even less sense.

While I sadly know the answer to why we do it (it's tied up into the normally-adaptive cognitive processes most people rely on to function), the fact of the matter is that we should be smarter than this. We can be smarter than this.

Just question yourself -- repeatedly. Be careful of over-generalization. Realize that in-group differences almost always exceed between-group differences. Keep in mind that people are people, regardless of anything else. Understand that you can misunderstand. Question yourself -- it bears repeating. Understand that statistical significance and practical significance are very different. Realize that "groups" of people -- however they're defined -- are almost always "fuzzy" statistical constructs. Watch out for logical fallacies. Don't expect perfection, mind... but always try to be right.

On a Recent Huffington Post Article

Around a week ago, this article was posted to the Huffington post.

Quite frankly, my initial reaction to it was to think that it was an April Fool's joke. The sheer absurdity of the juxtaposition involved in talking about healing divides while spewing hate speech is striking.

Yes, hate speech. It's pretty unambiguous. Reading through the comments, however, it quickly becomes apparent that people don't get it.

Well, some commentators do. Thanks, Kim! (And, of course, all of the other people who I don't know...)

At the moment, the commentators seem to be divided between those who engage in reification error and those who don't. This is... pretty typical, really.

In any case... let's see. The post characterizes the neurodiversity movement as being made up of "people with Asperger's Syndrome or higher functioning autism" (this is nowhere near true, and "high functioning" is considered insulting), describes ASAN as "a self advocacy movement for people with high functioning autism" (ditto), and ends by stating that "We aren't the enemies. Autism is." (Which qualifies as blatant hate speech).

I really don't know what to say here...

On Humor

Taken yesterday from my Facebook profile:

Alexander Cheezem just spent a while chasing after his pet sixteen-year-old, three-legged dog after she ran out of the house. I'm also still on crutches and can't put weight on my left leg. I'm fairly certain that some sort of disability humor can be derived from this, but I'm too exhausted to do so myself.

I believe this speaks for itself.

About Me

As part of the process of applying to Ph.D. programs, I've had to write a statement of purpose. What I wound up with was an unusually frank declaration of parts of my history that I don't normally talk about and of who I am today. It is perhaps longer than I'd originally intended, but that's fine by me.

I debated posting it here. Beyond simply being long and highly personal, parts are probably overly technical for a blog post. As such, I've reached a compromise of sorts and edited out two paragraphs, both of which are technical descriptions of past research projects.

In any case, the edited version is as follows:

My love of psychology started in the summer of 2002. At the time, I was a hopelessly naïve undergrad with all of the self-education and executive functioning skills that they teach you in a public school program for the emotionally handicapped. I was studying computer science even though I was quickly coming to understand that I wasn't terribly suited for the discipline and was overwhelmed by unfamiliar academic demands. In an attempt to find an easy class to bolster my GPA, I decided to sign up for an introductory psychology class.

It was a decision which changed my life.

For the first time, things which other people said and did – things which I'd never truly understood – started to make sense. Other people started to make sense, not because of projective heuristics which had never worked for me ("Put yourself in their shoes!"), but rather because of scientific theories laid out in a manner that I could actually understand. It took me a while to fully abandon my childhood dream of becoming a computer programmer, but once I did, I never regretted it.

Of course, this doesn't mean that everything was perfect. I found the scientific study of human nature to be endlessly fascinating, but it didn't exactly take me long to realize that many of the theories and rules I was studying simply didn't apply to me. My memory shows little to no primacy effect (and a very strong recency effect), my cognition tends toward algorithmic rather than heuristic processes, my sensory thresholds tested as far lower than those of any of my classmates… the list goes on and on.

In other words, it really drove home the fact that I was different, and that these differences from my peers were anything but minor. I even had a name for these differences: "Asperger's Syndrome".

When I'd first received the diagnosis, it had seemed like just another diagnostic label in a long series of often-inappropriate labels attached to me by psychiatrists. It was then that I started to realize that it was something more.

Throughout this, I continued to take every psychology class I could. My love of understanding, of knowledge, and of psychology was one of the few things that was constant during this time. It remains constant to this day – I am never quite so happy as I am when learning new things about my discipline of choice. I also came to enjoy cultural anthropology and scientific sociological approaches to small group dynamics, two disciplines whose overlap with psychology is rather difficult to deny.

At the same time, I began to seriously develop my ability to critically evaluate the scientific literature. I became interested in individual studies rather than books, I started to realize the gaps in our knowledge (although this process would continue to develop for a long time), and I started to seriously consider what I wanted to do with my knowledge.

Still hopelessly naïve and buying hook, line, and sinker into the oft-repeated clinical rhetoric that Asperger's was distinct from "proper" autism and was a more "mild" form, I started to both over-complicate and oversimplify things in my head. Desperately trying to understand how I was different from my peers, I sought to understand autism, figuring that the best approach to understanding answering this would be to understand the differences between the "autistic" and the "normal" groups, with myself being somewhere between the two. A number of details about my neurology and the way my brain works somehow got lost in the mix.

I felt that the best way to understand myself would be to come to understand the differences between an autistic mind and a non-autistic mind. To do this, I believed that the best place to start would be to run a series of external validity studies on the more noteworthy studies on non-autistic psychology, starting with Kahneman and Tversky's classic heuristics and biases studies. This would produce a baseline of sorts – not only of the areas in which differences could be found and targeted for further investigation, but also of those areas in which autistic and non-autistic processes were similar or the same.

Much to my disappointment, I soon found that while such studies had been done on occasion (e.g. De Martino et al.'s 2008 paper on framing effects), they'd been done only in a piecemeal and ad hoc fashion, and were often interpreted through a biased framework. I wanted to rectify that.

By this time, I had graduated and decided to spend some time getting clinical experience, both to shore up weaknesses in my understanding and to learn about autism-related clinical practice. At the same time, I used the time I was no longer spending reading coursework-related materials to focus more on reading about autism and related topics.

It took a while, but I came to understand just how naïve I had been. Tracing a number of the claims that I had taken for granted back to their origin, I soon discovered that many of them were based on shaky evidence – or were simply made up in a number of cases. I discovered that many of the researchers whose conclusions I'd previously accepted had little to no empirical basis for their statements, and that even the DSM description of autism had some pretty serious issues (e.g. the assertion that most autistic individuals are mentally retarded; see Edelson, 2006 for review and discussion).

I saw the state of the modern autism clinical community. I met children who'd been restrained and secluded by schools that didn't know how to deal with them. I saw intelligent, loving children drugged into a stupor by their clueless and frustrated parents. I met teenagers who had suffered even worse bullying than I had been in my own childhood. I met desperate parents who, not understanding scientific medicine, took pseudoscientific treatment approaches that endangered their beloved, if misunderstood, child's life. I read absurdly dehumanizing books about people on the spectrum, some even going so far as to dismiss the idea that we could have any sort of innate claim to humanity (e.g. Barnbaum's The Ethics of Autism).

I also both met and read the writings of "properly" autistic adults who were and are very much like me, facing many of the issues that complicate my life. I found others like me, and a community of people who both understood and accepted me. Bit by bit, my naïveté was stripped away.

It was in the middle of doing this that I, in an attempt to learn more about psychology and to attain clinical credentials useful in the world of autism, applied to Nova Southeastern University's postgraduate applied behavior analysis program. I learned about the early history of behaviorism, about biases in research, about the practical consequences of woefully inadequate ethical codes which are drastically under-enforced, and far, far more.

I also learned about the utter cluelessness and spectacular naïveté of many of today's professionals. In one notable incident, I had to correct a classmate – who had been working in the field of autism services for years – on the statement that the vast majority of autistics were mentally retarded (and got fervent denials of my correction even after I cited the relevant reviews). In another, my class reacted with shocked horror when I pointed out just how a professional could manipulate a client's family to worsen the client's self-injury (and provided a plausible, if highly unethical, motive for doing so). The thought that a professional who would put financial gain before a client's welfare could exist was apparently shocking to them. There were countless other such incidents, some of which involved my teachers.

This isn't to say that everything was bad (and, in fact, this was far from the case). It is to say that I started to understand just how badly things needed – and still need – to change. What had started as a simple quest for self-understanding grew to be more, because understanding is needed to produce that change. The practical consequences of ignorance are too great to ignore.

And, accordingly, I came full circle. I still want to conduct the external validity experiments I'd originally intended to, but I've come to understand that the importance of them – and of other, similar research – extends far beyond the realm of academic understanding and my personal quest for knowledge.

The fact that gaining that knowledge involves doing what I love and exercising my strengths is just icing on the metaphorical cake.

On Attitudes

I don't think any regular readers of this blog will be terribly surprised to hear that the sort of attitudes they take and encourage their members to take is one of the things that most continuously frustrates me about the various parents' groups in the autism community.

It is worthwhile, however, to once and a while contemplate just what a healthy attitude is. It's also worthwhile to acknowledge that organizations dedicated to other disabilities often get it right.

I was recently reminded of this by a series of ads by United Cerebral Palsy. Some of them were especially classic.

These aren't all recent, of course, but they do help to illustrate what a healthy attitude towards a disability consists of. Now if only the autism organizations would start to follow UCP's lead...

Another Example of Bias in Science and the News

I'll also have to admit that neuroscience isn't my area of expertise... or even an area of particular interest for me (beyond the subfield of cognitive neuroscience, which is of interest to me to the extent to which it provides useful evidence for theories in cognitive psychology). This isn't anything against the field -- I just don't personally enjoy reading these studies nearly as much as I do other sorts.

That taken care of, a recent MSNBC piece contains the following quote from an autism researcher whose name they didn't spell (but I very strongly suspect, based on my knowledge of autism researchers, the pronunciation given to the researcher's name, and his stated institutional affiliation to be Dr. Eric Courchesne -- please correct me if I'm mistaken):

We discovered that at birth the brain is near-normal in size, but by about twelve months of age the brain has grown too large, too fast, which suggests that mechanisms that regulate how the brain grows have been derailed in this disorder.

I pulled this specific quote because it's an excellent demonstration of a peculiar form of normocentric bias that pervades much of the autism world. There are a number of other problems with it, but for now I just want to focus on that one. It's worth noting that there are a number of other spectacularly problematic quotes in the piece, however.

I was going to go on a rather long rant about the subject, but then I realized that someone else had already done a pretty spectacular job of highlighting the problem. In essence, he's assuming that there's a single, "good" course of brain development (the one that most children show) and that all deviations from this course must be harmful. This is not the case.

Another case of "abnormal" growth that I can point to is in the hippocampi of London taxi drivers, a direct result (as far as we can tell) of the fact that they have to memorize a simply absurd amount of information regarding the layout of a pretty large and chaotic city... unless they navigate by GPS, and those that do don't show the "abnormal" growth I'm talking about.

Given the known functions of the hippocampus, this shouldn't be too surprising.

So I won't deny that the patterns of growth the doctor is talking about are interesting. I do think, however, that his interpretation is completely inaccurate and highly biased. If anything, I think the reports he's citing are evidence in support of the EPF model of autism... but we'd need further research to get something directly citable (without a lot of interpretation and discussion) as evidence in a primary paper on the subject.

On the Media

As I noted in a previous post, I had my wisdom teeth out recently. I'm only starting to come out of the narcotic haze of the painkillers now (and will need to take another shortly), so my plans to start job-searching will have to wait. No, this isn't because of the pain -- it's because of how badly the painkillers effect me. Still, while I have a few lucid moments, I might as well comment on all of the stuff I've missed.

For one thing, I haven't been able to read any peer-reviewed journal articles. This... really, really sucks, from my perspective. More than any of the other effects of the hydrocodone they gave me, the fact that it pretty much destroys my attention span to the point that I can't read research articles drives me ready to tear my hair out.

This does, however, present a somewhat unique opportunity as I go over the news I've missed. This entry is going to be of a special format -- as I catch up, I'm going to post a brief summary of each article dealing with autism, a link, and a comment on just how offensive the media coverage of the story was.

To start with, take this piece, whose main offence was to equate all developmental disabilities. As this is supposed to be reporting on abuse of persons with developmental disabilities... this really shouldn't be the case. The nature of the disability in question should be at least stated. It is insulting to spread the stereotype that all persons with developmental disabilities are "mentally incompetent".

Any broad category of disabilities covers a huge range of issues. The term "physical disability", for instance, can cover anything from a trick knee to quadriplegia. "Developmental disability" is only different in that it covers a greater variety of issues... many of which are only issues because of the lack of available societal supports.

On the other hand, the article does a good bit to highlight issues of abuse. I have mixed feelings about it.

Next, we have this piece, dealing with an Aspie contestant in a talent show, deserves particular mention for being exceedingly odious. For one thing, the entire piece is based not on what Mr. James (the contestant in question) can or can't do, but rather on a judge's prediction on whether or not he can cope with the stress of being on the show.

The language of the article itself, however, is so blatantly offensive it's absurd. Even the title is offensive -- "Asperger's sufferer will not..." indeed! The first line of the article repeats the theme: "The X Factor contestant Scott James, who suffers from Asperger's syndrome..."

Excuse me. Asperger's is a description of the way your brain's wired. You don't suffer from Asperger's (or autism) any more than you suffer from liking classical music (and, in fact, it's harder to separate "Asperger's" from the rest of you than it is said like). Saying that someone "suffers from" Asperger's (or autism, or...) is around as offensive as saying that someone "suffers from being Jewish".

Next, a local piece on the whole sign fiasco. Decent coverage... except I'm going to need to withdraw my earlier declaration of respect for Ms. Wallace. When the heck will these people realize that the cancer thing is even more offensive?

Then there's this piece which deals with an Aspie surfer... and deliberately calls up the whole lack-of-empathy stereotype. Enough said.

Next, this bit on the murder of a twelve-year-old autistic boy. This article actually manages to avoid being offensive. Way to go, UPI! Of course, the incident itself is another story, but at least the coverage wasn't bad.

This article on a summer camp for autistic kids actually looks pretty cool. Beyond its continuous reification of autism and oversimplification of the research, the article actually makes the program look decent... which should not be taken as an endorsement. All that really means is that the program isn't setting off any red flags based on this article.

This article covers the opening of a new school in a spectacularly uninformative fashion. Kudos to the author, though, for its opening line.

An article in the National Post details the (hopeful) end of a truly obscene saga of an autistic Canadian who got trapped in Kenya. Nothing too bad about the article, but, again, the story itself is pretty offensive.

According to this piece, an autistic child whose school was attempting to deny him the ability to bring his service dog with him won a victory in court. I do, however, feel sorry for Ms. Crook. While it involves skipping out of the chronology of the articles, it's worth noting that there's a considerably more offensive follow-up story by ABC here.

Really, when will the media learn that Autism Speaks doesn't speak for autistics?

Anyway, next up is a Salt Lake Tribune article on a couple who's been charged with abusing thier autistic son. Again, good coverage for a nasty incident.

This piece tries to hold out an autistic nineteen-year-old who recently became an Eagle Scout as an inspiration. At least it's better than most such attempts... which isn't saying much.

Finally, the Onion's latest effort in mocking Obama concluded with a pretty damn offensive bit about Biden and Asperger's.

Well... that's a few days in the news for me. No, this wasn't really atypical.

P.S.: It looks like the Psycho Donuts fiasco has come to an end. Cool.

Edit: It may just be the painkillers kicking in, but I find this incredibly amusing for some reason.

Lack of Drama?

First, a quick confession to make: I haven't seen Adam yet. I very much want to see the movie, but haven't had the chance due to other events in my life.

That said, I was reading the salon.com review of the movie, and was particularly struck by certain sections:

Autistic and Asperger's characters in movies are only beginning to move beyond the "Sidney Poitier phase," in which members of previously despised or misunderstood minorities are presented as symbols, saints or seers -- whose most important function is to provide other, more relatable and "normal" characters with the opportunity for moral and spiritual growth.

and

I understand that filmmakers are caught between a rock and a hard place in depicting this issue. If you make a thriller in which a serial killer or a child molester just happens to be a person with Asperger's, it would be seen as resuscitating ugly and untrue stereotypes. So instead we get a subdued, minor-key weeper, utterly conventional and glum, in which an Asperger's/non-Asperger's couple teach each other valuable life lessons.

The thing is, there's no shortage of potential for good movies with Aspies (or even all-out auties) as major characters. I'd love to one day see a movie (dramatized or otherwise) about the founding of ANI or the ASAN. Hollywood wouldn't even have to dramatize them much (except maybe for "believability"!) to get a good, if quirky, film out of either.

Of course, the two movies would necessarily be very different in tone -- ANI is very much a community-building organization and its story would be much more of a heartwarming, "feel good" movie than the ASAN's (which, by contrast, is very much an "dissatisfied underdog(s) try to change the world" story).

Perhaps a story of someone just going through life, dealing with constant descrimination? Voice-overs are excellent tools for narrating a character's thoughts, even if the actor "can't speak" about their opinions "on-screen". This sort of film could be excellent in exposing the ways our society subtly (and often not-so-subtly) discriminates against autistics.

I could go on and on... but, in the end, I know that I'll never make these films. I'm a researcher at heart, not a filmmaker.

On the other hand, there are others who I hold great hopes for... although I doubt that any of the above will be the movie(s) to show a true image of autism to the world.

I wouldn't hold great hopes for someone if I didn't have confidence that they could come up with better ideas than I can, now would I?

Unemotional?

When I was a child, I used to laugh at all of the kids complaining about the generation gap between them and their parents -- my father is older than most of their grandparents. While some of my peers grew up hearing war stories about Vietnam, the ones I heard were decidedly different. You see, my father's eighty-eigth birthday is in a few months. He took time off from college to fight in World War Two.

Now, however, he's in the hospital. About an hour and a half ago, I found out the results of the latest tests. Simply put, my father is suffering from progressive heart failure.

When my mom told me this, I didn't know what to say. I've always known that Dad was old. Frankly, it's been rather hard to miss... but he's always been so energetic, so healthy, that the natural implication never really settled in, emotionally speaking.

Now, though... I keep thinking back on the times we spent together, what Dad has always meant to me. He isn't perfect. He's human. But... he's my father. I love him.

Mom didn't need to tell me what the doctors said about prognosis and the like. I know damned well just what the diagnosis means... especially to someone his age. Fortunately, they caught things relatively early on and think that they can do a number of things to help.

I want to go visit him, but I don't want him to see what this news has done to me. I know I won't be able to completely hide things from him, but I can certainly try to compose myself and do it... and if I didn't try, I know that I'd never forgive myself.

I'll be doing exactly that in a few minutes.

It's things like this that make me laugh at the fools who say that autistic people don't have emotions or can't care for other people. It's harder to find a more baseless stereotype... but it keeps perpetuating anyway. I'd normally try to find some sort of witty retort or other statement, but, frankly... I'm not in the mood. I have a visit to make.

Of Mothers and Mothers

There is nothing I hate hearing more than dichotomous theories about people -- that is, any attempt to divide people into two groups and neatly pidgeonhole people into one group or the other. That said, I can't deny that any community has a homogenizing effect on the people in it.

This is also true of the various groups and camps of the parents of autistic children... except that they're also part of a larger community. Between member interchange, between-group exchanges, and the emphasis on support, a number of truly absurd and harmful ideas have become nearly mainstream.

It doesn't help that the quacks take as much advantage of this as they can, making as many quick bucks as they are able... at the expense of the children who they're being paid to help.

Often, however, the attitudes that these "biomedical" scams promote are more harmful than the treatments themselves... which is quite impressive given just how harmful some of them are.

Recent posts at Age of Autism have stirred up something of a storm on this topic. Admittedly, it's a bit of a tempest in a teacup -- which is to say that it's pretty darn small as storms go -- but it already produced a nice little kick in the pants for the AoA idiots.

Said article is one of the most eloquent expressions of what's wrong in the community of parents of autistic children that I've ever seen. Way to go, Michele!

Edit 7/21/2009: See here for another excellent response.

A Lecture

Today, the practicum students at my site had a training. Officially titled, "The Behavior Communication Connection" and subtitled "The Nature of the Connection", it was essentially a lecture on the differences between modern ABA-based techniques (notably including PBS techniques) and the crap that some idiots practice and have historically practiced.

This isn't to say that modern ABA-based techniques are perfect. It's to say that they're better than the ethics-challenged stupidity that some people equate with them. Now if only we could get people to stop practicing said ethics-challenged stupidity...

In any case, other than one slide, it was a fairly decent presentation... although I will admit that I made my fair share of points and am evaluating it with those incorporated.

That one slide was entitled, "Why do Students with Autism have Difficulty Communicating?" Leaving aside the person-first formulation (and why is it that the people promoting this sort of language never ask the people with disabilities themselves? It's not like we've been keeping our opinions secret...), the answer was quite revealing.

Specifically, it stated: "Children with autism do not have the skills of typically developing children that assist in the acquisition of communication skills."

The most revealing part of this is the fact that it proceeded to give ten examples. Of them, six were false and four were drastic oversimplifications.

Autistic kids lack the ability to maintain attention? ... yeah. Right. This is even funnier given that the next item states that autistic kids lack the ability to shift attention. The contradiction should be pretty obvious.

Autistic kids lack the ability to take the perspective of others? Disregarding the fact that this is a skill which neurotypical kids "lack" relative to adults, my experience has been that autistic kids are quite good at taking the perspective... of other autistic kids. The fact that they can't take the perspective of non-autistic kids is something that's a given, but neurotypical kids can't take the perspective of autistic kids, either. Issues of this sort happen cross-culturally, too. I mean... people from other cultures blow the tiniest things out of proportion. What the heck is the big deal with accidentally showing someone else the bottom of your shoe?

Yes, that's sarcasm.

The next item, that autistic kids have overselective attention, is so rediculously oversimplified that it's not even funny. I've commented on this before, but autistic sensory systems process data in ways that are completely different from the ways that non-autistic sensory systems do so. Of bloody course they're going to find different things salient!

This is followed by a statement that autistic children lack in the ability to use new experiences to relate to previous experiences. Umm... no.

The slide continues along these veins for a while. I would, however, like to answer the question from my own experience.

Why do autistic students have difficulty communicating?

Because the people they're trying to communicate with ignore them when they try.

On Frustration

Throughout my clinical career, there have been a number of things which I've very much wanted to say, but haven't for a variety of reasons. These range from me being generally too polite to actually say them to me believing that doing so would be counterproductive.

For a variety of reasons, this post has been backdated. I won't say when -- or where -- I wanted to say these things, although I will elaborate (somewhat) on the contexts if asked. I also will freely edit this post to add additional unsaid comments as they occur -- and will not remark on my so doing. I won't necessarily add them to the end of the lists, either.

For the most part, all of this is to prevent these comments being tied to any given workplace or person. Given the nature of some of these, they could damage the reputations or careers of the people involved, and that is not my intention. It is, however, my intention to highlight some of the things that go on in the clinical field... and why I greatly prefer academia.

To professionals:

• If I'm implementing an extinction program, please don't undermine my efforts and reinforce an extinction burst.
• This goes double if the program is for aggression. Do you think it's easy to not react when a child is hitting you? Those punches can hurt.
• Damnit, when a child hits a teacher, the correct response is emphatically not to give the child cake!
• For the love of God, lady, how the Hell did you manage to pass the BCaBA exam without knowing what extinction is?
• Lady, I read the clinical research for fun. If I'm doing something you don't understand, just ask me. I'd be more than happy to explain. If you just interrupt, undermine my efforts, and then blame me when things get worse, it really isn't going to help my opinion of you or of your professional conduct.
• If you have a behavior plan to work on, please don't work on it in the classroom while the kids are just sitting there, bored. It's not only unprofessional, it's actively against the best interests of the children. This goes double if the plan isn't even for one of the kids in the classroom.
• If you work two full-time jobs which involve acting as caretaker of a mix of autistic children and adults, I am bloody well going to assume that you know what autistic literalism is. I am also going to assume that you know what autism is. Proving these assumptions wrong is not a good way to impress me with your professionalism.
• I attempt to hold myself to very high standards of both professionalism and compotence. However, I also expect certain minimum standards of these from my colleagues. If you are working as a behavior therapist, this means that I expect you to know what certain basic concepts -- like "extinction" and "reinforcement" -- are, and I do not expect you to attempt to ridicule me for using these terms.
• I had more than enough bigotry and ridicule during my secondary education, thank you very much.
• Anti-autistic bigotry and ridicule of autistic difficulties have no place whatsoever in a special education environment. Yes, I very much will complain to our boss about these things if you engage in them.
• Lady, I'm autistic -- with all that implies. I flat-out told you that well before I ever started to work with you. If you don't understand what that means, you have no business working in a school for autistic children. You have less business trying to teach them.
• If you need something, bloody tell me. I'm not necessarily going to pick up on it intuitively.
• If a child has been warehoused -- and probably abused -- for half of her life, chances are that institutional damage is a factor. More than a little sympathy and kindness is called for.
• Please stop talking in front of the children as if they weren't there.
• Your bigoted rant is making me physically ill. The fact that it is being made in front of the children is not a redeeming factor.
• ... you have two autistic sisters, work in the field, and can't deal with autistic literalism?
• "Personal style" is valid, to a point, but developing a true personal style does not consist of taking pieces and aspects of flawed therapies and methods and merging them into a personally-appealing whole. It consists of finding a way to operate within guidelines and boundaries of best practices that you are capable of and comfortable with.
  

To parents:

• If your son has stomach problems which have required him to be hospitalized in the past, and the hospital found a series of massive cysts in his stomach... please take him to a real doctor and not some natropath. I very much do not enjoy the way he screams in pain while clutching his stomach during lunch. I also very much do not enjoy trying to teach children who are in considerable pain, and I know exactly how much even a minor stomach lesion can hurt.
• (In regards to the previous) No, I do not think that some "all-natural" digestive enzymes will solve the problem.
• Lady, your nineteen-year-old starting to show an interest in pictures of scantily-clothed women is not a sign of precocious puberty or overly high testosterone levels... and certainly not a medical indication that he should be chemically castrated by the Geiers!
• (Smiling) No, I don't think that your child's motor difficulties are "the autism". I think they're a direct result of the megadoses of Vitamin B6 you've been giving him for the last few years.
• When your child starts to exhibit symptoms of acute hypervitaminosis A, you immediately stop all supplementation. You do not just reduce the dose by ten percent or so.
• Please stop feeding your child candy whenever he punches me... or you... or anyone else, for that matter. Do I really need to explain what you're teaching him by doing this?
• No, giving him a toy is not an acceptable substitute!
• Please start showing some common sense. (Over and over again...)
• No, hookworms are not a good thing for a child to have!
• Children coming to school stoned out of their mind tend not to learn much. This is not an autism thing.
• ... let me get this straight. You're doing the body ecology diet and yogurt enemas and yet you think you're not into the woo?

And I could think of plenty more...