Is Autism a “Public Health Crisis?”. Part 6
Instead of providing a direction and an emphasis on those recognized and existing instructional, behavioral, psychological, medical, and social supports that can make a difference in the lives of children with ASD and their families, the report goes on to emphasize the need to “monitor, assess, and translate important neurobiological and biomedical advances and other scientific breakthroughs rapidly occurring in ASD research” (California Blue Ribbon Commission Report on Autism, 2007, p. 43). The report fails to identify specific ‘breakthroughs’ while correctly acknowledging later on “…there are no widely accepted guidelines on exact program components of effective ASD interventions” (p. 54). The fact that the Commission’s report did not clearly and effectively define the difference between best practice, promising practice, and pseudoscience will continue to challenge and increase the likelihood of a crisis with regards to the relationships between families, clinical providers, and service agencies in California and across the country.
With regards to these differences in opinion, the Commission’s report (2007) goes on to acknowledge that it is “(not) clear what constitutes optimal treatment based on an individual’s age, symptoms, and level of functioning” (p. 54), that “parents, services, and experts may come to different conclusions about the needs of a particular child” (p. 55), and that there is a “shortage of trained and qualified providers” (p. 55). The Commission still insists, however, “service agencies (remain) responsible for providing appropriate interventions [italics added for emphasis]” (p. 55). Beyond the incongruity and risk present in this statement, it appears to open the door even wider for more conflict, litigation, and expense between families and service agencies, while failing to provide direction, proper resources, or acknowledgement of what is known to be effective for persons with ASD. It is quite possible that the “complexity, intensity, and economic costs of services to individuals with ASD” (p. 12) identified by the Commission risks being further intensified by this report.
After all, how can schools or service agencies, like California’s Regional Center system, be expected to compete with the neurobiological, biomedical, and neurological models of ASD continually emphasized but never delineated? The strengthening of effective community-based services and supports with an emphasis on the schools in combination with an instructionally-driven, behaviorally-based intervention model should be prioritized for children with ASD. Effective instruction is the key while differentiated and individualized lesson planning should be the focus (Tomlinson, 1999; Wehmeyer et al., 2002). The fact that the Commission listened to and considered a wide range of testimony and feedback is commendable. This author was strongly drawn to the message of collaboration and interagency cooperation, a point the report strongly supports to include the benefit of ‘demonstration projects’ both from within and across service agencies towards the enhancement of a seamless set of family and child-friendly services.
The Commission should move strongly towards validating and strengthening the range of services and instructional models which are currently in place. The key is to first recognize the available resources, knowledge, investments, and services that currently exist, and to offer renewed funding, training, and oversight via applicable public agencies to include the schools, social services, and the regional center system. Without this awareness, the Commission’s prediction of extreme and escalating costs of services to children with ASD and their families is more likely to become a self-fulfilling prophesy.