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Understanding Echolalia and Gestalt Language Development Time Second Keynote Address: 12:45 Presenter/Facilitator Barry Prizant, PhD, CCC-SLP Back to Course List < Back About the Course In this address, Dr. Prizant unpacks the complexities and brilliance of Gestalt Language Processing (GLP), a developmental language style commonly observed in autistic individuals. Often misunderstood as merely repetitive speech, echolalia can be a critical step in natural language development. Dr. Prizant will demystify the stages of GLP, explain how echolalia serves meaningful communicative and emotional functions, and share practical strategies for supporting language growth in gestalt processors. This session offers educators, clinicians, and caregivers a respectful, strengths-based approach to honoring diverse paths to communication. Objectives: Participants will define key terms related to Gestalt Language Processing, including echolalia, mitigated echolalia, and analytic language development. Participants will explain the stages of Gestalt Language Development and how echolalia fits within a typical language acquisition framework for gestalt processors. Participants will integrate at least two strategies for supporting communication development in children who are gestalt language processors, grounded in affirming and developmentally appropriate practices. Barry Prizant, PhD, CCC-SLP Barry M. Prizant, PhD, CCC-SLP is among the world’s leading authorities on autism, and is recognized as an innovator of respectful, person- and family-centered approaches for individuals with autism and neurodevelopmental conditions. With fifty years of experience as a scholar, researcher, and international consultant, he is a visiting scholar at Brown University, a certified speech-language pathologist and Director of Childhood Communication Services, a private practice. Barry is coauthor of The SCERTS Model: A Comprehensive Educational Approach, now being implemented in more than a dozen countries. He has published four books, more than 130 articles and chapters and has received many awards, including the Honors of the American-Speech-Language-Hearing Association (their highest recognition), the Princeton University Eden Foundation career award for improving quality of life for persons on the autism spectrum, and the “Divine Neurotypical Award” of GRASP, the world’s largest autistic self-advocacy organization. He has been a two-time featured presenter (2013, 2017) at the United Nations on World Autism Awareness Day. His recent best-selling book, Uniquely Human: A Different Way of Seeing Autism is now published in 22 languages, was selected as the featured book on autism by the United Nations in 2017, and was ranked by Book Authority as #1 of the “100 best books on autism of all time”. With a wealth of inspiring stories and practical advice from thousands of children and older people on the autism spectrum and their families, Uniquely Human conveys a deep respect for the qualities in people on the autism spectrum. It offers a compassionate and insightful perspective that has been called “life-changing as well as uplifting”. Barry also co-hosts a podcast, Uniquely Human: The Podcast , with his friend, Dave Finch, an autistic audio engineer and best selling author. Speaker Disclosure: Dr. Prizant received a speaking fee for this course.

< Back SAPD cadets learn how to respond to incidents involving people with autism Tiffany Huertas Apr 2, 2024 SAN ANTONIO – San Antonio nonprofits have teamed up to create a training program to help San Antonio police cadets better understand autism spectrum disorders. Any Baby Can of San Antonio, a local nonprofit serving families with children and youth facing serious health or developmental challenges, is part of the group behind the program. Robert Peaden, director of Autism Services at Any Baby Can San Antonio, said it teaches cadets how to respond to incidents involving people with autism. “What they look like when it comes to recognizing from level one to level three on that spectrum. And then after that, after about two hours of instruction there, we do about two hour instruction of the response phase,” he said. Peaden has a passion for helping parents navigate autism spectrum disorder. His son Logan was diagnosed with Autism Spectrum Disorder when he was two years old. “My son was diagnosed at two years old at Triple Army Medical Center in Hawaii when I was in the United States Air Force,” Peaden said. Peaden’s love for his son brought him to the program. “I would describe my son as the nicest person you’ve ever met in your life,” Peaden said. Any Baby Can San Antonio teamed up with the nonprofit Family ADDventures to start the program last year. “My mission is to keep children with autism out of the school to prison pipeline,” said Nicole Santiago, CEO of Family ADDventures. Santiago is passionate about this training and explains the reason it started. “One of my clients was unlawfully arrested and I filed a complaint and we had a meeting and the police were open to us coming in to train,” Santiago said. San Antonio Police Department officials say every cadet class is now taking the trainings. “We talk about different sensory needs. Different communication needs. So, for example, I have communication boards I use. So sometimes if someone becomes with their anxiety, they become non-speaking, they can use the board to point to what they want to say,” Santiago said. The Centers for Disease Control and Prevention reports about 1 in 36 children has been identified with autism spectrum disorder. “Autism is a developmental disability or disorder that is diagnosed in childhood, and it affects communication chiefly, it also affects social skills, sensory processing,” Adrienne Gaither, director of caregiver empowerment at Autism Community Network said. The Autism Community Network also played a big role in the program and is involved in the training. “I think the most important strategy is to be open minded and also to take a step back when they encounter a person with autism and really think about what accommodations can be made. How they can read the communication of someone who might have a communication impairment. And also to draw on the training that we’ve providing and not to be scared of that call,” Gaither said. “The training is super helpful because it helps develop a level of competency in our new officers. These are cadets preparing to become officers serving the community, and it helps them to develop relationships and to learn how to interact with really all people from our community,” Jeremy Spencer, police officer at SAPD and instructor at the training academy said. April is National Autism Awareness Month and KSAT community is partnering with Any Baby Can to help raise awareness. Tune in for the KSAT Community “Town Hall: Understanding Autism”, hosted by Tiffany Huertas. You can watch live at 2 p.m. on Tuesday, April 16 through the KSAT+ streaming services. Also, Any Baby Can San Antonio is hosting its 20th Annual Walk for Autism on April 20, 2024 at Palo Alto College. Watch Autism Community Network's Director of Caregiver Empowerment, Adrienne Gaither, work with other community nonprofits to educate the SAPD about autism here: https://www.ksat.com/video/news/2024/04/02/sapd-cadets-learn-how-to-respond-to-incidents-involving-people-with-autism/ Previous Next

< Back We Should Tell Children They Are Autistic As Soon As Possible Shannon Des Roches Rosa Jun 18, 2022 Thinking Person’s Guide to Autism (TPGA): Why did you decide to do research on the “right time” for parents to tell autistic children they’re autistic? Bella Kofner : I wanted to do the research because parents may not know when is it the “right time” to tell their children that they are autistic. Parents may be struggling on how to start a conversation about how to tell their children about their autism, and when to tell. I also wanted to do the research because this reminds me of my own experiences as an autistic person. I was diagnosed at the age of three with autism, and I was first told about my autism when I was ten years old. I did not really think too much of my autism until I got older. When I got older, I reflected on my life experiences and my autism. After taking the time to reflect, I feel very comfortable with my autism to the point that I tell people about me being autistic. TPGA: Did the results of your research surprise you in any specific ways, or were the results along the lines of what you expected? (Or was it a mixture of both?) Kofner : It was a mixture of both for the results. What surprised me was that participants who learned about their autism later on in their life had more positive emotions when they first learned about their autism, which contradicts the second hypothesis about learning one’s autism at a younger age would be associated with positive emotions about autism in adulthood. One result that aligned with what I expected was that the findings supported the first hypothesis that learning one’s autism at a younger age was associated with heightened well-being and quality of life (QoL). TPGA: Why is it important for autistic kids to know that they’re autistic, according to your respondents? And in your personal opinion? Kofner : In my personal opinion, it is important for autistic kids to know that they are autistic early on because this would allow children to start developing as people while taking their time to understand who they are as a person with autism. The more that parents wait longer to tell their autistic kids about their autism, the more likely that children will have negative feelings about themselves as they get older. When children are told early on about their autism, this will lead to children gaining self-awareness and feeling confidence in themselves which can have a positive impact on their well-being and quality of life as adults. Based on the responses of participants, there are examples of why it is vital for autistic kids to know about their autism at a younger age. One participant, who first learned about their autism at the age of eight, said “I suppose it helped me better understand why I felt and acted different from everyone else.” The same participant said about their feelings about their autism now ” I am proud about my identity. As someone who also researches autism, I have a greater appreciation toward learning more about my own identity and how that differs from others.” This shows how the participants express positive emotions from when they first learned about their autism, to feelings about their autism now. TPGA: What are your primary recommendations for parents, when it comes to how and when to tell kids that they’re autistic? Kofner : When it comes to how, parents should tell their children in a comfortable and safe environment for the child to be in. Parents should tell their children by using language that the child can understand. Parents have to take into consideration the child’s developmental level and how to explain autism to their child in a way that allows the child to understand themselves. Parents should not assume that the child is going to react this way or that way, so parents have to know how to respond to the child’s reaction in ways that show that it is ok for the child to feel this reaction and know that they are there for the child to answer questions or to talk about anything. When it comes to when, it is personally up to the parents to decide about telling their children about their autism. But, parents should not delay in telling their child about their autism because the child may question who they are and what their life was like in adulthood if they do not tell their children early on. So, it is better for children to be told early on about their autism so that children can grow as individuals, and understand themselves as they go through life as autistic people. TPGA: How were your survey participants selected? Do you think the demographic profile of the participants affect the results in any ways? Kofner : Participants were recruited through social media or at universities. Participants that were interested emailed the third author and received a link to do an online survey in Qualtrics. Students that were enrolled in any institution of higher education were allowed to participate. A total of 78 autistic students were the participants in the study. The demographics did not affect the results in any way. TPGA: Most of the researchers on this study were themselves autistic. How do you think that having autistic researchers affects the direction and focus of autism research? Kofner : Having autistic researchers is very important in autism research because it is important for all voices, including autistic people , to be represented in autism research. If autism research does not incorporate autistic researchers, then people may struggle to understand autism and topics in autism research. This study was the first study that demonstrates that learning one’s autism at a younger age may have positive impacts on emotional health among autistic university students. This study is an example of how the perspectives of autistic people are vital because how can people be educated in autism and tell their children about autism if there are no autistic researchers. Over time, the knowledge of autism has grown in society and people are accepting of autism. So, it is up to us to encourage people to collaborate with people with autism in autism research. By including autistic researchers in autism research, we can bring awareness about topics in autism research and we can learn in the process on why autistic researchers play a vital role in autism research. TPGA: Did you have any self-identified autistics among your survey respondents (meaning they were never formally diagnosed, or their parents never told them but they figured it out)? If not, do you plan to do research in this area? Kofner : 14.1% of participants found out about their autism on their own. That means that they were not told by their parents about their autism and learned from other sources which include the media and autistic people. TPGA: Is this study going to lead to more research about the timing of autism diagnoses discussions between parents and autistic children, and if so, what are your goals for that research? Kofner : This study can start to address concerns that parents have reported in prior literature in terms of how to start a conversation with their child about their autism. Future research should focus on asking participants when they were diagnosed and when they learned they were autistic to examine if the timing of the diagnosis itself or potential delays between being diagnosed and learning one’s autism impact outcomes in adulthood. Previous Next

< Back Noelia Cheatham Billing Specialist Noelia Cheatham joins our team as a Billing Specialist with twenty three years of work experience with an Early Childhood Intervention Program (ECI). Her work background also includes working as a Special Education Teacher’s aide, interpreter and Peer Counselor for the Women Infants and Children Program (WIC). At WIC she taught health related classes in English and Spanish. Noelia is very involved with an orphanage in Mexico, Casa Hogar. She organizes drives for school supplies, school uniforms, and bi-yearly summer festivals for the children. She has two grown children and her hobbies are crafting, gardening and baking. Noelia is excited about new opportunities with ACN and helping to serve the community. noelia.cheatham@acn-sa.org (210) 435-1000 ext. 5008

< Back Kathryn "Katie" Benson, MPA Director of Outreach and Education Kathryn “Katie” Benson has a Bachelors degree from Florida State University, and a Masters degree in Public Administration with a concentration in Non-Profit Management from the University of Texas Arlington. She spent 14 years total in the public education setting as a special education teacher. Ms. Benson’s other work experiences include volunteer coordinating for San Antonio events, directing and over-seeing productions at a local theatre, and managing community programs at another local non-profit. She is excited to be part of the ACN team, where she can use all of her myriad experiences in one place. In her spare time, Katie enjoys trivia and board games with her family, as well as spoiling her three fur babies. Katie is the proud sister to a neurodivergent adult. katie@acn-sa.org (210) 435-1000

< Back Capital Campaign Building tomorrow together, your donation is our foundation. Autism Community Network officially moved to 535 Bandera on July 24, 2023. We are extremely grateful to the initial capital campaign partners for believing in our mission and partnering with ACN to lead the San Antonio and South Texas in strength-based, neurodiversity affirming care for the youngest members of our community. Our capital campaign remains ongoing, and we extend an invitation to future partners to become an integral part of our transformative capital campaign. This is not a simple call for funding, rather an opportunity to be a change agent in the care of children showing developmental delay or have a diagnosis of autism. Partnering with ACN to help manifest our vision of becoming a nationally recognized center of excellence for the assessment and treatment of children with autism will: Decrease critical wait times for the most vulnerable facet of our population Create a truly sensory friendly, welcoming environment for all visitors Provide space for play areas and community gatherings to include: an outdoor playground and sensory garden, indoor/outdoor space for Camp AUsome!, a state of the art, multipurpose community center adjacent to the main building, and an expansive parking lot for outdoor food/school drives and holiday events Expand upon current services with additional therapy rooms, kitchens to support ACN's new Feeding Empowerment Program, and larger gyms for therapy and group activities Partnering with ACN in this way will allow children on the spectrum to be absolute contributors to our society. Our children will push the envelope of what humanity is capable of with a team of professional and familial caregivers walking beside them. Let's get started

< Back Adrienne Gaither, OTR, CSIPT, C/NDT Chief Programs Officer & Occupational Therapist Adrienne Gaither has been a pediatric occupational therapist for over 25 years. She received her degree from The University of Texas Health Science Center at San Antonio and began her pediatric therapy career, eventually gaining experience in every setting available for the provision of children’s Occupational Therapy services. Adrienne has had the opportunity to serve as a member of ACN’s team since 2009. She is a Pediatric Autism Communication Therapy Accredited Practitioner, supporting families impacted by autism through dyadic coaching and a part of ACN’s interdisciplinary diagnostic team that uses a strength-based, neurodiversity-affirming approach to address the unique presentation of the child and family. Adrienne also holds specialty pediatric certification in the Sensory Integration and Praxis Tests (SIPT) and has completed advanced training in Neurodevelopmental Treatment (NDT) for children. Locally, Adrienne had the privilege of serving on the planning team for the development of Morgan’s Wonderland; in particular, contributing recommendations for the Sensory Village portion of the park. In addition to her work with ACN, Adrienne is a part-time Program Director and Sensory Consultant with Kinetic Kids, Inc., a local non-profit agency providing sports and recreation activities for children and teenagers with special needs. When she is not working, Adrienne enjoys life with her husband, 2 children, and 2 dogs, running, singing, and traveling. adrienne@acn-sa.org (210) 435-1000

< Back Arjai Ramos Front Desk Coordinator Robert Ramos, Front Desk Coordinator, brings 25 years of medical experience to Autism Community Network in the following areas: mental health, children with disabilities, and oncology. He is the parent to four dogs and one cat. He loves spending time with his family and friends. When not working, he can be found riding through the hill country checking out local Texas wineries. robert.ramos@acn-sa.org (210) 435-1000 ext. 5000

< Back Volunteer Volunteer today, and transform tomorrow! At Autism Community Network, we believe that change starts with dedicated individuals like you. That's why we invite you to become a vital part of our volunteer family. By volunteering your time, skills, and passion, you can contribute to our neurodiversity affirming care for children and caregivers in San Antonio and South Texas. Whether you're interested in hands-on projects, sharing your expertise, or simply lending a helping hand, there's a place for you here. Whether you can spare a few hours a week or a couple of days a month, your contribution matters and is deeply appreciated. Ready to be the change? Let's work together to make a difference that resonates far and wide. Let's get started

< Back 'Emergent and transactional': How Jonathan Green is Rethinking Autism and Interventions Brady Huggett Aug 28, 2023 Brady Huggett Hi, I am Brady Huggett, the enterprise editor at Spectrum. Recently, a paper was published in the journal Child and Adolescent Mental Health. The paper was written by Jonathan Green, a researcher and clinician at the University of Manchester at Royal Manchester Children's Hospital, and Manchester Academic Health Science Center, all in Manchester, U.K. The article is titled “Debate: Neurodiversity, autism and healthcare.” There have since been a few commentaries in response to Jonathan's article, and it has generated some online chatter, which is not unusual around these topics. So we wanted to talk with Jonathan about this paper, why he wrote it, what his key themes are, and also discuss the early reaction to it. That's what I've done. That's the focus of this interview. We talked on August 3rd, 2023, morning for me and, and mid-afternoon for Jonathan in Manchester. And before we get going, I'll say that if you are listening to this on a podcast app, on spectrumnews.org , the posting for this interview includes links to some of the papers that Jonathan and I discuss. So that's all you need to know. We'll start here, where I'm asking Jonathan how this paper came about. [transition music] All right. So, Jonathan, I think the first thing that we should talk about is your impetus for writing this paper. What were you thinking about and how'd you come up with this topic? Jonathan Green Yeah. Um, thanks, Brady. Um, I think the, uh, the occasion of writing the paper really came from the current, uh, very fluid, contentious, and often really difficult situation for clinicians, uh, with the current status of autism, debates around neurodiversity, etc. I was asked to write the paper, actually, after I delivered a lecture about the history of autism- history of the autism concept, and how I thought it had altered over time, and, uh, what I thought the current- uh, what I called the paradigm shift, uh, real, real turning, pivoting points now were, and-and they asked me to write this, uh, this contribution after that. I've worked as a clinician in this field for 30 years or so, and as also a clinical scientist. And I just know the complexity for, uh, clinicians in this field at the moment and the pressures they're under. So this is partly to-to help them. Brady Huggett Can I ask, you-you said you were asked to write the paper, that's by the journal, the journal asked you to write the paper? Jonathan Green Uh, yeah. That's exactly, yeah. Brady Huggett Yeah. OK. And I was gonna ask too, who-who you thought the audience was, and it's for clinicians. I mean, really you're trying to lay forth some new thoughts for clinicians here. Jonathan Green Yeah, I've- that-that's-that is the case, uh, Brady. I, um, I have written some other papers on this topic recent- the last couple of years, which have really been addressed as much or more to the, uh, broad scientific, uh, uh, professional audience, um, and also to the neurodiversity community, and of course, in this modern, uh, media age, you know, that I-I'm totally aware that what I wrote in this paper, although I had clinicians in mind, um, of course, other people will read it, and they have, and they've commented. So, uh, you know, that's-that's just normal these days. Brady Huggett So you, I think, most recently, you-you wrote on this topic in October of 2022. Jonathan Green Yeah. I wrote a-a paper called “Autism as, um, Emergent and Transactional,” um, which is- was a theory paper that really folds into this. And perhaps it would be useful just to explain the origin of these ideas, um, which really lay-lay behind the-the argument in the paper. So earlier in my, uh, career, I, uh, my, uh, my first, uh, area of, uh, research, developmental research actually was in individual different psychology, and particularly in temperamental variation in newborns and, uh, early infancy and its consequence. Uh, so I was, um, very much involved in the-the notion of individual difference and its consequences in development. And within that, the study of temperament historically, uh, I think was a very interesting paradigm where the downstream consequences of early individual difference, which was largely assumed to be genetic in origin, was, uh, plotted in longitudinal studies. And this notion, uh, arose of the so-called transactional relationship between individual difference in development and the world around the individual. So I was imbued in that and in the sort of intervention research that was done early on, which showed that actually, with the right kind of intervention early on, one could actually mitigate the downstream effects of early difference and improve, uh, downstream outcomes, but within this transactional context. So, long story short, around 2000, uh, the turn of the century, um, I began with colleagues to apply this idea to autism as a developmental difference. And basically, we showed in these programs really quite strikingly that actually, you could alter the transactional dynamics early on with autistic difference. And actually, uh, more strikingly than that because that had- that's pretty common knowledge in a lot of intervention procedures, but then actually this-this altered and improved downstream autism, uh, phenotype. So this was not done with high-functioning autism. This was done with kids who are largely, uh, minimally-- well, uh, or, uh, didn't have free speech and had reduced IQ. This underlay the paper I-I wrote in last year on, uh, “Autism as Emergent and Transactional.” And you can see how the logic came from that. That's-that's-that's the second bit. And the third bit that underlays this paper is my engagement with the neurodiversity community and autism advocates over the last five, six, seven years, which has been quite intensive. And I've really engaged them, uh, quite deeply in phenomenological work. And, uh, thinking about their own experience and understanding the-the neurodiversity community and advocacy movements and all of those three things together then led me to the kind of position that, um, I'm talking about in the-in the paper here. Brady Huggett And so it's- OK, those are the roots. And you've sort of applied this to our current moment, if you will. And I think early in the paper, you said that there is a receding horizon for the scientific goals around autism, which I thought was a really interesting way to say it. Can you sort of expand on what you mean by that idea, that this is a receding horizon? Jonathan Green That was-that was put sort of purposefully like that to just- I-I think, um- I mean one anecdote to-to exemplify it, when I first worked in autism seriously in the '90s, uh, I was part of the first large, uh, international autism genetics consortium, which was looking at molecular genetics and-and at a big population level and big data. And we started out, I mean, I was junior in the-in the consortium, but, uh, which was led by Michael Rutter at that time. But, you know, I realized that it started out with basically a modeling that there would be probably six genes of main effect that would actually determine autism. That's where it was at the time, around 1995, right? And what I've seen in that consortium, and we've seen over the- over the time, of course, is thatthat wasn't the case, that we've now got maybe 1,000 genes of sm- uh, of small effects, CNVs, plus of course, uh, uh, proportion like 14 percent or so of-of single-gene disorders of main effect that are associated with autism. So- but if you look at common familial autism, this is a polygenic condition. And, um, so there's a-a receding horizon on the genetic silver bullet, right? Which is what we started with. There's also a receding horizon on, um, biomarker identification, not only a genetic, but at a neuroscience level. So I've been involved in a lot of the early babysibs projects in terms of early neurodevelopmental studies. Bottom line, we haven't got a-a simple, um, uh, early marker, predictive marker for-for autism in that sense. I- so that's what I mean by a receding horizon, Brady, um, and the idea that, you know, which some, uh, people misunderstand, that a lot of genetic research basically implies eugenics i-is-is kind of scientifically nonsensical. We'll never find a-a gene, um, marker, a prenatal gene marker that would enable that. Brady Huggett Yeah. So that led you to write, I think that you called it an- right now we are- there's an unparalleled flux in our understanding of autism, right? Jonathan Green Yeah. Brady Huggett And-and as you said, 1994, everyone sort of thought they-they- we would figure it out, it'd be very simple. That's been not the case at all. And now we're sort of in this area where, um, it's not clear what might be known or what even isn't known yet. And that, I think is what led you to sort of say, "Now we need to think about treatment differently." Jonathan Green That's true. I mean, I don't wanna under-underestimate, uh, and under-respect the huge science work that's gone on and the amount we've learned from it, but I think what we've learned Brady Huggett Oh, sure. Jonathan Green What we've learned is complexity and Brady Huggett Yes. Yeah. Jonathan Green -uh, you know, we need to take a different paradigm view. And, uh, the other aspect of the paradigm shift is-is like what we-what we mean by autism. I mean, one of the sections in my paper was, “What is ‘autism’ anyway?” And, you know, and that's come under a lot of debate. And I do think that the advocacy movement has brought into play for us in the clinical science community vividly the lived experience of autism, and that- and the importance of that in our consideration. Brady Huggett OK. So, if we have this idea that autism now is, uh, emergent and transactional, and that's gonna lead hopefully to a new way to treat aspects of autism, I suppose. Take me through how that works and sort of what's needed to be uniformly believed, or not maybe not uniformly, collectively believed in order for that to work. And you-you've laid out three or four things that need to happen. Jonathan Green Yeah. I mean, what I suggest is-is that we need to have a more of a shared understanding that what we call autism is rather a dynamic entity. You know, when I first started in the field, there was this, like, quite preformist idea, really, that autism was a neurological, uh, disorder, uh, that emerged over time as sort of biological emergence. Um, and, uh, it was nothing you could do about it. Certainly, in the U.K., it was total therapeutic nihilism that you could do anything about this unfolding, right? Um, and I think we-we do need to change that. I think the work I've done in-in our therapy program and other people too have shown that no, this- there is, you know, within limits, there is, uh, work that one can do on the environmental aspects around autism that can really cha- substantially change things. So I think we need to do that. And, um, you know, I think we need to seriously realize that we can actually invest in really good early environmental adaptations right from the get-go that could make at least some difference to the evolution of the phenotype. And I've-I've suggested in the paper that, um, we really need to recast our intervention model to be much more proactive, more, um, preventative in orientation, uh, rather than reactive and firefighting, uh, which is so much of what goes on at the moment. Uh, but there's also the need, and this is another aspect of the paper, uh, we need to, uh, avoid culture wars around, um, you know, uh, fighting about what autism is and, um, which is a really unfortunate aspect at the moment. And-and so I wanted to try and create a kind of shared language, um, model that-that would be at least reasonably acceptable to, um, both the, um, the neurodiversity community and also to the, uh, community of, um, adults and parents whose, uh, whose children and adults who have major disability, you know, and no one is underestimate- certainly not me, since I've worked with them for 30 years, underestimating, uh, the-the importance of that and the need. So, uh, this, the idea that, you know, that intervention is-is-is inappropriate is-is not compatible with clinical experience. And there's- so there are real dilemmas here that we have to really, uh, talk about together. Brady Huggett Yeah. So the-the idea basically in this, you know, as you said, we're in this unparalleled flux of our understanding, is to maybe make a shift from, "Hey, we're looking for these genes so that we can affect these genes," to autism is emergent. How do we change the environment so that this autistic person, this autistic young child, flourishes so that their outcome is improved? Jonathan Green Yeah. That- in a- in a nutshell, that is exactly the paradigm, and it-it-it-it-it-its orientation is-is to, um, accept and value the difference, but to try and optimize the outcomes as much as one possibly can. And what we can do in health care, I think, is this early intervention piece, but of course, it links with societal change, uh, with change in the workplace and all sorts of other things that are beyond earlier education, that are beyond health care to actually within the same model of accommodation to improve flourishing and outcomes. Brady Huggett You just- you-you just mentioned, and you mentioned this in the paper, that there's been this sort of fracturing of the landscape. The neurodiversity movement has brought like, uh, just a ton of attention to things that were not being looked at before, honestly, and that- and that has bumped up against the medical community, which is sort of looking at autism as this medical condition, right? This is the social model versus the medical model that you-you alluded to before, and you're hoping the paper might sort of help stop the fracturing. Do you think it's been able to do that? I know it's early days, of course, the paper's not even out in print yet, but what is your thoughts about this after having been out for a while? Jonathan Green Uh, well, obviously, the paper in itself won't do it, but, um, I think that I am committed to a-a-a common language. I think, uh, as I- and I wrote about this a bit more extensively in the-the 2000-the 2022 paper on, uh, emergence and transaction that, you know, we have-- part of the whole remit of clinical science has been to integrate the basic biology, basic science, clinical practice, and-and social understanding, youyou know, to have a unified view is-is so powerful. And, um, so how are we gonna do that? Well, we do need a model, and that's what I'm trying to present here. We do need a model of thinking, but then of course, we need, um, dialogue, and we need engagement with each other. And, uh, I try and do as much of that as I can myself and others that are also doing it. And they'll need to be given on both sides. That's obvious, uh, because there is a, uh, a lot of incompatibility. You know, one thing I-I don't want my model to-to underplay is the, um, the disability aspects of a lot of autism and/or to overplay how much treatment can do. I think it can do a lot, and we've shown this empirically what it can do, but it-it's not a magic cure. And I think from the other side, there's-there's too much defensiveness about the-the felt threat from neurodiversity language, um, the social model and, uh, advocacy community. And, uh, and it-it sort of, uh, I mean there are de- there-there are trigger areas around which this revolves, of course. I mean, one is the notion that, um, any intervention or treatment is, uh, is basically destroying autism or under- or-or trying to wipe it out, uh, that sort of eugenics narrative, which is, you know, a-a tough one. And, um, when I'm in the room with autistic advocates and, uh, we can really talk this through, I-I think and hope that there's a- there can be a bit of mutual understanding here. And I hope that the kind of treatment model I'm proposing is more acceptable because this is not about changing or wiping out autism, it is about, uh, supporting it. You know, that's the argument we've made, and I think generally that's been understood and supported by- Brady Huggett Yeah. Jonathan Green -many. Brady Huggett Yeah. So, let-let me-let me ask about that 'cause I think-I think when- you tell me what-what feedback you've gotten on this paper already, but I think the idea would be for a neurodiverse advocate, if they-if they read this paper, they would say what they're doing is trying to lessen autistic traits and therefore make me less autistic, and that is what they're fighting against. Jonathan Green Well, yeah. This is-this is, uh, a complex, very nuanced, um, uh, argument here. I mean, it's-it's-it's so interesting because it comes up against autism identity. So, there's a social identity model and argument, but a lot of it gets tied to this behavioral phenotype definition diagnosis. Now, this is a complex argument because if people then say, "Well, no, you're- then you are taking away my autism identity," what I say is, no, I'm not, I'm-I'm really not doing that. But the-the nature of autism development is like all our developments, all our identity develops in over time. You know, none of it's pre-formed. None of us have a preformed identity, and I don't believe autism identity is preformed either. Um, you know, and so one has to-to take this developmental argument, but of course, in the social space, autism identity is a binary, and it's a valued identity. And so that is a very reala very real dialogue and challenge, a mutual challenge I-I'd say. But from a- I think what I'd be saying, and the- and this is where I think the phenomenology is important, is that we actually think from the phenomenology work that we've done that the-the core neurodivergent phenotype may lie slightly be-behind what the behavioral phenotype currently tells us, so that if you listen to autistic people and their experience, actually, their experience doesn't really map onto the DSM category. You know, their-their experience is of an overwhelming world, a huge sensitivity, which often has great benefits as well as difficulties associated with it, an attentional style, which is highly focused at times, and then, uh, feels pretty, uh, chaotic at other times, but again, has some very, uh, powerful strengths to it. And all of this, of course, is from the, um, verbal advocacy and this is often what's criticized about. It's not representative, but it-it's a very important group, and these people can tell us what it feels like to be autistic. And what they tell us doesn't map onto DSM very well. We may want to alter the phenotype a bit, which may in turn alter what people think of as the autistic identity. And it's not the same as the ADOS thing that we measure and that we change because what I'm a-arguing is that what we are changing is downstream effects, which is not quite- which is slightly different. So it's a-it's a subtle argument, but I hope that's clear. And one other thing I wanna say is that intellectual disability associated with autism is another big issue here. So that for children who are non- and-and adults who are non-communicative, who have- or nonspeaking, um, who-who are really cognitively, uh, delayed and autistic, what's their lived experience? Is that a very different kind of thing? And a lot of the time, we just don't know that because we haven't been creative enough in being able to access their experience. And I think that is a-an area that we're gonna need to really look at. Brady Huggett I-I wanted to ask a thing too because you-you mentioned- in the paper, you actually mentioned that you'd worked on another paper with three autistic colleagues of yours, and you sort of went back over your earlier lives and you realized there were some similarities in the way that, um, you developed versus the way they developed, and also some differences. But on this-on this paper, you're the only author, but did you run this past some of those same colleagues? Jonathan Green Uh, yes. Yes. The, um, uh-uh, these ideas have been, uh, talked about with them. I mean, I'm not- I'm not saying that they would agree with everything I've written here, but they're familiar with these, uh, with the model that I've put forward. And, um, I think I've learned a lot from them, which has also illuminated thethe model. So, uh, Jo Bervoets, who I, uh, reference in the article is one of those colleagues that I wrote that paper with. So, uh, I'm not- I'm not claiming they'd sign up to this, [chuckles] but, um, you know, that- I-I hope that this is something- my informal feedback is that this is, uh, something that's at least to-to some of those colleagues is-is an acceptable kind of way of framing the thing. Yeah. Brady Huggett Yeah. A couple of things I wanna ask you and then we're done, but one is, what feedback have you seen? Again, it's not out in print, but it is online, and as you said, it has been disseminated widely. What feedback have you seen? I mean, I have some- I have seen people online saying things like, "This is eugenics," as you mentioned, right? Um, what-what feedback have you gotten? Jonathan Green Uh, well, there are- there are a couple of, um, published commentaries on the paper. So the-the journal, uh, commissioned, uh, actually three commentaries, uh, but two are- two are in at the moment. Um, and so they're available, so you can see those. One is from a-an autistic, uh, advocate, uh, academic, and the other from a clinical science, uh, colleague. Um, so there, you'll see there- I mean the-the, um, if I distilled it down, the-the-the feedback from the clinical science colleague is largely, um, I-I would say supportive of the model. Uh, the-the autistic, uh, advocate, uh, colleague, particularly focused on a-a lack of, um, in this, what- in my paper, on a lack of attention to autistic identity. And I think she's right to do that. I don't think I have talked about that, uh-uh, very much. Uh, partly it's because I don't feel really qualified to do so. She makes some points that, you know, that-that there's not enough attention to that. And I, you know, I do accept that that is a-a legitimate area where we have to really wrestle and discuss together about those things 'cause there are some paradoxes in there. Otherwise, um, online, yeah, there's been, uh, some of the sort of Twitter commentary around eugenics, which is, you know, I think is a bit, um, it's like any-anything that in- that-that suggests intervention at this current time can provoke that, uh, kind of feedback. And I hope I've tried, really tried hard to, um, to explain why I think that this, the kind of intervention certainly, that we are talking about here, um, its-its aim is to- is to validate and to support, uh, neurodiversity rather than, uh, get rid of it. Um Brady Huggett Yeah. Jonathan Green -so Brady Huggett Yeah. Jonathan Green -uh, you know, you do what- one does one's best with that. Brady Huggett Yeah. So just the final question. You know, this-this paper mentions neurodiversity throughout, and the word has, I mean, grown exponentially since it was first coined. And I think, almost that everybody has their own definition of what that word means, and I'm wondering how you would define neurodiversity. Jonathan Green Um, yeah. So I-I don't think I would want to, um, hazard an overall definition because, as you say, this is a term that has been used so differently by different people. I mean, of course, it-it began as a-a-a term of, uh, assertion really, of the importance of um, you know, neurological differences. Um, and it-it-it came from the, you know, neurodiversity community, um, uh, as a-as a- an idea. And I think it really applies to the idea that there is a range of brain difference. Uh, and I suppose whatwhat is, um, controversial about it or-or radical about it, is how wide you take that net. You know, we-we could, you know, think about, um, dyslexia, dyspraxia, dyscalculia, you know, these things are all very, uh, you know, and they're not really pathologized as it were really within the developmental science. And then you- then you can think about ADHD, uh, another neurodevelopmental condition that is, as it were, "pathologized", intellectual disability, Tourette syndrome, anorexia, schizotypy. Uh, so it's, uh, how broad you-you embrace the differences here. So that's an important thing, is like there's a range of, as it were, normative variation. And it's how broad, and I think the neurodiversity community would often wanna argue for a very broad definition of-of-of this. So, uh, and then, of course, there's the idea that-that the concurrent with that is the-the fact that the people should have equal social rights, um, and, uh-uh, so as a sort of social activism. Um, you know, I think that then if you are- OK, so how do I respond? Well, basically the idea is in essence intuitive to me from, as I said, I started off with the idea of individual difference, um, uh, research. And a lot of this is just a reframing of that. Uh, you know, we know a lot of the genetics research has suggested there are a lot of common genetics, uh, between these different conditions. I'm personally more of a splitter than a lumper. So I like to keep, uh, these-these individual conditions, I think have very particular characteristics. And I don't wanna lump them all together into one thing, but there'sthere's-there's is clearly a family of neuro-neuro difference. [chuckles] So, yeah, I think, um, neurodiversity is quite an interesting concept, both scientifically in terms of shared genetics. Um, you know, and you maybe were, uh, familiar with the essence, uh, model of, uh, Chris Gillberg, which he's talked for many years about how all these conditions are all somewhat part of a one group. Um, and I've personally not really agreed with him, but, you know, it's there, that he's argued that for many years. And I don't think there's a big difference between that and a lot of what the advocacy community say from their own lived experience perspective, to be honest. And I think we can learn a lot from each other about that. Brady Huggett Uh, that was a- one of the longest definitions of neurodiversity I've ever heard, but-but a complex one. I like it, thank you. Thank you. Um, that's-that's all I had, Jonathan. Uh, thanks for taking the time to talk about your paper and Jonathan Green OK. Brady Huggett -uh, good luck with it. Jonathan Green Thank you. Previous Next