Search Results

< 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

Building Relational Trust and Sense of Safety Between you and your Child Time AM Breakout Session - 10:00 AM Presenter/Facilitator Anna Paola Smith, LCSW, PACT Accredited Provider Brenda Orozco, LMSW Back to Course List < Back About the Course When children feel safe in their relationships, they’re more able to learn, communicate, and grow. This session explores how stress, trauma, and the world around them can uniquely impact autistic children—and how parents and caregivers can be a calming, empowering presence. Grounded in evidence-based Pediatric Autism Communication Therapy (PACT) strategies, this presentation will give families tools to support emotional safety, strengthen connection, and build everyday moments of trust that help children thrive. Objectives Participants will be able to explain how stress and trauma can uniquely affect autistic children’s nervous systems, communication and relationships. Participant will explain how secure, affirming relationships with primary caregivers support regulation, communication, and confidence in autistic children. Participant will be able to identify and integrate specific Pediatric Autism Community Therapy strategies that promote relational safety and trust. Anna Paola Smith, LCSW, PACT Accredited Provider Brenda Orozco, LMSW Anna Paola Smith attended The University of Texas at Austin where she received her BA in Psychology and her Masters degree in Social Work. She has had the opportunity to work with children and families in the school, hospital, and clinical settings. Anna Paola's interests lie in family systems and how the development of one child may impact the entire family unit. She started a sibling support group at Autism Community Network to provide siblings a safe space to share their own experiences. Anna Paola also provides routine follow-ups for caregivers after their child receives an autism diagnosis and is a bilingual Pediatric Autism Communication Therapy Accredited Practitioner, supporting families impacted by autism through dyadic coaching. Anna Paola is part of an interdisciplinary diagnostic team that uses a strength-based approach to address the unique presentation of the child and family. Speaker Disclosure: Ms. Smith receives a salary from Autism Community Network. Brenda Orozco received her Bachelor of Arts in Social Work from St. Edward's University and a Master of Social Work from Texas State University. She has extensive experience providing case management services to children with disabilities and their families. Brenda specializes in working with uninsured and underinsured individuals to coordinate resources to address their health needs. Her desire in working with clients has always been to show them how to navigate systems and how to advocate for themselves. Brenda enjoys being active in her church community, planning family fun nights, and learning about automative/home repairs. Speaker Disclosure: Ms. Orozco has no pertinent information to disclose.

< Back ADULT & TRANSITION AGE SERVICES About Adult & Transition Age Services As individuals with autism transition into adulthood, they face new challenges related to employment, independent living, and social engagement. Our resource library provides information on services and programs designed to support adults with autism, including day programs, vocational training, supported employment, and social skills groups. We also provide information on legal and financial planning options for families preparing for their loved one's transition into adulthood DAY PROGRAMS The Arc of San Antonio - Life Enrichment 210.490.4300 Web: www.arc-sa.org 13430 West Avenue, San Antonio, TX 78216 6530 Wurzbach, San Antonio, TX 78240 Beach House Arts Day School 210.549.0067 Web: bhaonline.company.site 114 N. Ellison Dr. #403 Serving both teens and adults with IDD. CALAB Activity Center 210.647.0191 Web: www.calabinc.com 6470 Heath RD., San Antonio, TX 78250 Vocational Program, Day Habilitation, HCS Services and other services offered. Educare Community Living Corporation 210.979.7009 3700 Belgium Lane, SA TX 78219 Business Office & Day Habilitation Helping Hands – UUMC 210.690-7303 Web: https://www.helpinghandsdayprogram.org 5084 De Zavala Rd., San Antonio, TX 78230 Helping hands is a part of the special needs ministry at University United Methodist Church. Helping hands is a pre-vocational day habilitation program that serves higher functioning adults with special needs who need a place to grow, develop skills, and establish life-long friendships. Helping Hands offers daily tasks and activities to adults who have intellectual and developmental challenges. Homelife And CommunityServices; Inc 210.736.3334 Web: www.homelifeandcommunityservices.com 2401 Wilson Blvd, San Antonio, TX 78228 A Home and Community Based Services (HCS) provider agency; must have Medicaid and be registered through AACOG (Alamo Area Council of Governments) to qualify for services with this agency. Offers community support; day habilitation; respite; employment assistance; individual competitive employment; dental and nursing services; physical therapy; dietary services; counseling and day habilitation summer camp; serves Bexar County residence of all ages. Mission Road Ministries - Adult Programs 210.924.9265 Web: www.missionroadministries.org/unicorn/about 8706 Mission RD, San Antonio, TX 78214 Mission Road Ministries provides residential; day service; employment guidance and vocational programs for adults with intellectual and other developmental disabilities (IDD). To qualify for assistance; individuals must have a diagnosed IDD and have Medicaid. Private pay is also an option for Non-Medicaid clients; to request assistance; call Monday - Friday 8:00 AM - 5:00 PM. Mother Earth Adult Daycare 210.691.1778 Web: www.motherearthadc.com 8464 Barron RD, SA TX 78240 Mother Earth Adult Day Care is a non-residential facility providing exceptional health care services to Adults 18 and older, Individuals with medical and mental health needs, those requiring daily nursing intervention. Medicaid constituents who have a disability are qualified. Private pay is also accepted. RMI (Reaching Maximum Independence) 210.656.6674 Web: www.rmihomes.org 6336 Montgomery Drive, SA, TX 78239 HCS/ICF-MR/Private Pay Life Enrichment Center SAFIRE (San Antonio Fitness, Independent and Recreational Environment) 210.236.7662 Web: www.safireso.org 11111 Iota Dr, SA, TX 78217 No more sitting around all summer wondering what is available for your individual with intellectual disabilities age 14+. Each day SAFIRE will offer large group recreation games, individual workout programs and a social experience like no other; must be able to function in a 1:8 ratio of staff to clients and participate in small group games appropriately. Cost: $125.00 weekly. Summer Camp: Daily Weekly or Monthly Enrollment, extended hours available. SA Life Academy 210.382.1247 Web: salifeacademy.org St. Andrews UMC 722 Robinhood Place, San Antonio, TX 78209 Relationship building, academics, community involvement, sound mind and body and expressive creativity. For applicants 18 years and older. Seniors 2000 210.435.1800 Web: www.seniors2000.com 4396 Callaghan Rd. San Antonio, TX 78228 VOCATIONAL PROGRAMS Easter Seal Rehabilitation Head Injury & New Beginnings Program 210.614.3911 Web: www.easterseals.com 2203 Babcock Rd, San Antonio, TX 78229 San Antonio Lighthouse 210.533.5195 Web: vibrantworks.org 2305 Roosevelt, San Antonio, TX 78210 Vocational services for visually impaired Southwind Fields 210.526.1567 Web: www.southwindfields.com 11835 IH-10 West, Suite 306, San Antonio, TX 78230 The Southwind City Locals program is designed for men and women of a wide variety of abilities. Whether living in their own place, or at home with a caregiver, a Southwind Local Advisor will come to them. If living at home is what's best for now, we'll help build skills to reach new levels of independence towards tailor made goals. City Locals already living in the community, may stay in their current place of residence, should they choose to do so. Those moving to the area, or who would like to relocate, may reside in an affordable Southwind partnership apartment complex, maintaining their own lease agreements, while enjoying the fellowship and community of living alongside other Southwind City Locals. City Locals receive basic case management services from our City Local Advisors, who will check in several times weekly to assess health & safety of the living environment, bus training (if appropriate), assistance with assuring bills are paid on time (if applicable), and the offer of assistance for financial management, employment search and retention (if applicable), medical needs, personal care, and independent living skills training. Workacccess, Inc 830.714.9280 Web: www.workaccess.us Oak Meadow Methodist Church 2740 Hunters Green, San Antonio, TX 78213 Youth and adult program provide work training and placements, with selfemployment support. Early childhood program for children with special needs. Previous Next

Our diagnostic pathway. ACN provides access to strengths-based, individually tailored autism screenings and medical diagnostic evaluations catering to children with referrals 0-5 years and 6 months of age and their families. Evaluations are offered on-site or via telehealth and can be completed in Spanish or in English. 02 Diagnostic Evaluation Currently, ACN offers two different diagnostic tracks dependent upon the unique presentation of the child and family determined at their screening. Diagnostic teams at ACN may be comprised of any of the following neurodiversity-affirming clinical specialists: a developmental-behavioral pediatrician, a pediatric neurologist, a psychologist, an occupational therapist, a speech-language pathologist, a behavior analyst, and/or a clinical social worker. All diagnostic appointments are completed within one day to make the process as convenient as possible for the family. Autism-specific developmental screenings Initial screenings, offered via telehealth or on-site, are performed by an expert autism clinician. Our screeners globally assess to determine developmental strengths, developmental delays, and/or neurodevelopmental differences that may impede the child’s ability to function and thrive. The screening assures that each family will receive immediate feedback and recommendations for supporting their child’s development. If determined to be necessary, the family will be guided in scheduling a diagnostic appointment with ACN tailored toward their individual needs. Additionally, the provision of this screener allows families an accurate idea of their child’s developmental profile and offers recommendations for other supportive services and/or therapeutic interventions while the family waits for full diagnostic evaluation. 01 03 Earliest Connection Clinic Our Earliest Connections Clinic (ECC) was launched in January 2019 with startup funding from Philanthropitch, and continues to flourish through funding from the United Way. ECC provides surveillance and diagnostic assessment for children between the ages of 6 and 36 months of age who are demonstrating developmental differences. Evidence suggests diagnosis of autism can be quite stable as early as 14 months of age (Pierce, 2019). Families noting early developmental differences in their children no longer need to “wait and see", but can team up with ACN to “watch and support”, empowering them to understand and connect with their child and to harness the malleability and neurological plasticity of a developing brain. 04 Case Management Following the diagnostic appointment, our social work team will reach out to help you navigate the “How are WE” and "What's next?" questions. We work with you to determine supports that may be added to scaffold each member of the family’s needs and to create a uniquely tailored plan for next steps your family may consider. Our goal at ACN is to serve as a continuous platform of support for families pre-, during, and following diagnosis. We invite you to the many quality-of-life resources made available to you through our organization. Additionally, we connect you with external resources that may supplement support for your family as you begin navigating your journey. At ACN, the family is our client, and we find that when the family system is supported, the neurodiverse child can thrive. How to start: Download our diagnostic referral form. To schedule an appointment for an autism-specific developmental screener, download our ACN Referral Form for your pediatrician to complete. Download Cost of Diagnostic Services We accept many forms of medical insurance, including Medicaid. Contact Vanessa Amaya at: vanessa@acn-sa.org Cancellation Policy Appointments with ACN are in high demand, therefore, we require a minimum of 48 hours notice for cancellation, which affords us the opportunity to offer the time slot to another patient. Late Arrivals Delays happen, however, if you arrive more than 15 minutes past your scheduled appointment time we will have to reschedule your visit.

< Back LOCAL Closer Look: Autism Community Network Felipe Aguilar Feb 4, 2024 Felipe Aguilar talks with Adrienne Gaither, Director of Caregiver Empowerment and Occupational Therapist, Autism Community Network (ACN) in San Antonio. Gaither provides a historical and organizational overview of ACN. She also describes ACN’s mission as it applies to providing care to persons with Autism. Gaither gives some practical guidelines for caregivers of children with Autism and talks about the importance of early diagnosis. She describes services and resources that ACN provides to children and adults with Autism diagnosis. Learn more at ( https://www.acn-sa.org ). Listen to the interview here: https://www.klove.com/news/closer-look/hot-topx/local-closer-look-autism-community-network-san-antonio-7191 Previous Next

< Back CASE MANAGEMENT & FAMILY SERVICES About Case Management Services Our case management and family services resources provide information on support services available to individuals with autism and their families. These resources can help families navigate the often-complicated system of autism services and find the help they need. Also, inquire about our in-house autism case management resources! CASE MANAGEMENT & FAMILY SERVICES AACOG, Alamo Local Authority for IDD 210.830.5020 Web: www.aacog.com 8700 Tesoro Dr., Ste. 800, SA TX 78217 Provides Eligibility Determination (autism is a related condition), service coordination for General Revenue Services and Texas Home Living program, enrollment into the Home and Community-Based services program, In-Home Family Support Program and admissions into Intermediate Care Facilities-MR and State Schools Any Baby Can of San Antonio 210.227.0170 Web: www.anybabycansa.org 217 Howard St. San Antonio, TX 78212 Provides case management, to families who have a child aged from newborn to age of 17. Provides crisis assistance, referrals, small group counseling, individual counseling, financial assistance and parent education for children with autism. ARC of San Antonio 210.490.4300 Web: www.arc-sa.org 13430 West Ave. San Antonio, TX 78216 FAMILY SUPPORT SERVICES: Provides a social service “home” for families and caregivers of individuals with intellectual or other developmental disabilities. Support Service Coordinators will help families connect to programs and find resources. Eligibility: all ages, no income restrictions, serving Bexar County and surrounding communities. COMMUNITY SUPPORTS CASE MANAGEMENT PROGRAM (CSCM): Provides comprehensive case management services for families who have a child/young adult(s) with special health care needs. Eligibility: Ages 3-21 years. Non- Medicaid eligible. Bexar and surrounding counties. COMMUNITY LIVING ASSISTANCE & SUPPORT SERVICES (CLASS): Contact Yolanda Fuentes, Director of CLASS Case Management at yfuentes@arc-sa.org . Provides individuals with disabilities access to the resources they need to live and work as independently as possible in the community. Case Managers coordinate services including provider care, specialized therapies, adaptive aids, minor home modifications and respite care. Eligibility: Must be actively enrolled in the CLASS Medicaid Waiver Program. Center for Healthcare Services - CHCS-ECI, formerly PACES 210.261.3300 Web: www.chcsbc.org 5802 S. Presa, San Antonio, TX 78223 O ff ering a variety of services for parents with children under the age of 3, who are experiencing developmental delays. Services include case management, family centered services, activities in familiar settings, and more. Mo family is turned away because they cannot a ff ord to pay. Free services for children on Medicaid. Other services provided based on family size and adjusted income. Previous Next

< 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

Our Services Autism Screening & Diagnostics The goal of our clinical services is to provide expert autism diagnostic medical evaluations backed by the latest research to children up to age seven. All assessments are offered in English and Spanish and can be provided in-person or via telehealth. Read More Innovative, Evidence-Based Therapies ACN offers the latest neurodiversity-affirming therapies targeting our clients' individual needs. Working with our expert therapists, you will develop unique goals tailored to your child and your personal family journey. Therapies are available in-person or via telehealth. Spanish may be available upon request. Read More BIG Futures Programming Autism Community Network provides innovative and engaging autism support services to families and individuals living with autism. From Camp Ausome! to our Fam Jams, we provide a way for autistic children and their families to socialize, engage in collaborative projects, and develop meaningful skills and relationships. Read More Training and Mentorship/Educational Programs Every week Autism Community Network provides training, educational programs, and learning opportunities. ACN is proud to be a teaching facility for the future leaders in autism care. Join us every Friday for Coffee and Connections, sign up for our blog, or share our event calendar with your network. Read More

Reserve Your Spot Now! Tickets, tables, and sponsorship information below. Bet on BIG Futures! Your donation makes a direct impact in the lives of the children and their families who walk through our doors each each day. With your support, we can continue to provide life-changing services at ACN. Why Support ACN? Event proceeds will be used to support autistic children and the people who love them. ACN provides diagnostic services, innovative therapies, camps and after school clubs, support groups, educational offerings, free community events and more. Save your seat! Choose one of the options below to purchase a ticket, table, or sponsorship! First name Last name Email(Required) Select your Ticket, Table, or Sponsorship opportunity Individual Ticket $200 Let's Roll Table $2,000 Lucky Hand Table $3,000 Royal Flush Table $5,000 High Stakes Table $10,000 Casino Table Game Sponsor $750 Cocktail Sponsor $2,000 Table Beverage Sponsor $2,000 Cigar Bar Sponsor $2,000 Champagne Sponsor $2,000 Number of Individual Tickets Order Now

Training. The Autism Community Network is dedicated to improving the lives of individuals with autism and their families through support, education, and advocacy. Our Caregiver Empowerment Program offers training for familial and professional caregivers, medical residents, student clinicians, education professionals, and the wider community to ensure that everyone who interacts with autistic individuals can provide them with the best possible care. 01 Coffee and Connections. Search Check out our quarterly and register! Coffee and Connection is our weekly virtual series that brings together experts in their respective fields to share insights and best practices on popular topics related to autism. From classes such as “Self-Compassion for Caregivers” and “Whisperings of the Sleep Fairy”, our series covers a broad range of important issues to help support autistic individuals and their families. Join us virtually every Friday from 9-10 am and connect with others in the autism community while gaining valuable knowledge and support. 02 Professional Conferences. Our organization is committed to providing a diverse and enriching array of professional conferences to support caregivers and professionals in the field of autism and neurodiversity. Our flagship event, the Annual Summit, is a must-attend gathering featuring expert speakers and a comprehensive program covering a wide spectrum of topics relevant to your work. Whether you prefer virtual or in-person attendance, this event ensures you stay up-to-date with the latest trends and developments in the autism community. For those seeking even more in-depth knowledge, Autism Community Network offers two summer intensive programs, “Neurodiversity University” and “Making ‘Sense’ of Autism.” Both programs delve deeply into the intricacies of autism and neurodiversity. The intensives equip attendees with invaluable insights and strategies to better support individuals on the spectrum. 03 Trainings on Request Search View class offerings At Autism Community Network, we understand the importance of community education and empowerment. We offer a range of training options that can be customized to meet the unique needs of your organization. Whether you require inclusive practices for your business or are seeking continuing education credits, our team can provide comprehensive group training sessions, ensuring that you and your colleagues are equipped with the necessary tools to create more inclusive environments. In addition to our diverse training offerings, we are excited to introduce "My Beautiful Brain," a specialized program designed for neurodiverse youth. This program empowers young individuals to embrace their unique qualities and understand what makes them exceptional. Through a series of engaging and interactive sessions, participants gain self-awareness and a sense of pride in their neurodiversity, fostering a positive self-image and enhancing their self-esteem. Our flexible training sessions can be tailored to your organization's specific needs and schedules, ranging from 30-minute workshops to full-day seminars. Furthermore, our Valero Community Center is available to provide an appropriate and welcoming space for your training and educational needs. We are dedicated to advancing education, awareness, and support in the field of autism and neurodiversity, and we invite you to join us in our mission. 04 Mentorships At Autism Community Network, we place a strong emphasis on mentorship as a cornerstone of professional growth and development in the field of autism and neurodiversity. Our commitment to fostering mentorship opportunities is exemplified through our participation in various programs and initiatives. One such initiative is our collaboration with UTHealth's Profectum DIR BASIC Certification Program, where we actively support and mentor doctoral-level occupational therapy students seeking to obtain certification in the Developmental, Individual Differences, Relationship-based (DIR) model. Our experienced mentors guide aspiring professionals through the certification process, providing invaluable insights and guidance to help them excel in their DIR practice and better serve neurodivergent individuals. In addition to the certification program, we offer mentorship opportunities through our intern and medical residents programs. These programs provide hands-on experience and mentorship for individuals at various stages of their careers, whether they are students, recent graduates, or medical residents specializing in autism-related fields. Through these initiatives, participants gain practical knowledge, refine their skills, and receive guidance from our seasoned professionals, ultimately contributing to the growth of a more knowledgeable and compassionate workforce dedicated to autism and neurodiversity. Our commitment to mentorship underscores our mission to empower individuals to make a meaningful impact in the lives of those affected by autism and related developmental differences. We believe that by nurturing mentorship relationships and fostering a culture of continuous learning, we can create a more inclusive and supportive world for neurodivergent individuals and their families. How to start: Learn more about our training programs. Excited to start learning? Contact us below, and we'll be sure to find the program that fits your specific needs. Enroll Cost of Training Cancellation Policy Cancelling a training requires a 48 hour notice. Our staff are passionate about helping the community. A cancellation may offer another organization the ability to take your place, or open a spot for our staff to work one on one with a family in need. Late Arrivals The policy for late arrivals is program specific, and based on the preferences of your organization and our presenters. If you are going to be late, we ask that you alert the appropriate parties in advance. Cost of training is tailored to your specific needs. For more information, contact Katie Benson at: Katie@acn-sa.org .