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< Back FUNDING & MEDICAID WAIVERS About Waiver Services Our funding and Medicaid waiver resources provide information on funding and support programs available to individuals with autism and their families. These resources can help families access financial support for necessary services and supports. FUNDING & MEDICAID WAIVERS AACOG, Alamo Local Authority for IDD 210.832.5020 Web: https://www.aacog.com/IDDServices 8700 Tesoro Dr., Ste. 160, 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 Bluebonnet Trails Community Services 844.309.6385 Web: https://bbtrails.org/autism/ 1009 North Georgetown St., Round Rock, Texas 78664 A family-centered approach to teaching individuals’ skills necessary to succeed in the home, school and community (Bastrop, Burnet, Caldwell, Fayette, Gonzales, Guadalupe, Hays, Lee, Travis, and Williamson counties). Camino Real Community Services 210.357.0300 Web: www.caminorealcs.org P.O. Box 725, Lytle, TX 78052 Early Childhood Intervention Services, Mental Health Services, Intellectual & Developmental Disability Services. Community Living Assistance and Support Services (CLASS) 877.438.5658 Web: Click Here Provides home- and community-based services such as respite care, nursing services, adaptive aids/supplies, home modifications and other related services; long interest lists. Disability Benefits Assistance 210.732.6078 814 West Euclid Ave, SA TX 78212 This program offers assistance and information for people with disabilities who are applying for benefits. Hill Country MHDD Centers 830.792.3300 Web: http://www.hillcountry.org 819 Water Street, Ste. 300, Kerrville, Texas 78028 Providing mental health, individual developmental disability, and substance abuse, services throughout the greater Texas Hill Country (Bandera, Blanco, Comal, Edwards, Gillespie, Hays, Kendall, Kerr, Kimble, Kinney, Llano, Mason, Medina, Menard, Real, Schleicher, Sutton, Uvalde, and Val Verde counties) Home and Community Based Services (HCS) 210.832.5020 8700 Tesoro Dr., Ste. 160, SA TX 78217 Intake application: Click Here About: Click here HCS is a Medicaid waiver program that supplies services and supports to Texans with an intellectual disability (ID) or a related condition so that they can live in the community. HCS services are intended to supplement rather than replace services received from other programs, such as Texas Health Steps, or from natural supports, including families, neighbors or community organizations. Social Security Disability Insurance (SSDI) 1.800.772.1213 Web: http://ssa.gov/ Social Security Disability Insurance (SSDI) is a federally run benefits program that provides aid to people who are unable to achieve gainful employment due to a permanent disabling condition. SSDI is financed by the Social Security tax. Therefore, any person that qualifies as disabled according to the definition provided by Social Security Administration (SSA); and who has paid Social Security taxes long enough to achieve sufficient work credits; can qualify for SSDI. Social Security Disability Insurance; also known as SSDI or SSD; provides income to individuals no longer able to work because of a physically or psychologically restrictive disability. SSDI is funded by payroll taxes and does not depend on the recipient’s income level; as it is based solely on work history and the degree of disability. Supplemental Security Income; or SSI; offers monetary assistance to low-income individuals who are at least age 65; blind; and/ or disabled. SSI pays cash benefits to supplement the cost of food; clothing; and shelter. Provides Medicaid coverage and monthly cash assistance to eligible individuals; eligibility is based on citizenship status, financial status and disability. TX Dept. Of Aging & Disability Services-Medically Dependent Children Program (MDCP) 1.877.438.5658 Web: Click Here The program provides services to support families caring for children and young adults who are medically dependent and assist with the transition of children in nursing homes. Services include: Adaptive aids; adjunct supports; minor home modifications; financial management services; respite services; transition assistance services and more. To qualify, applicants must have a child with a disability less than 21 years of age; be a U.S. Citizen or an alien with approved status who lives in Texas; be low income and eligible for Medicaid; must meet the medical necessity determination for nursing home care and cannot be currently enrolled in another waiver program. Call to get on the interest list. Previous Next

< 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

Clinician Track: AM Breakout Session: The Movement Sensing Perspective UNPACKED Time 10:00-11:15 AM Presenter/Facilitator Rosemary White, OTR/L Back to Course List < Back About the Clinical Intensive Day In this presentation, Rosemary White, OTR/L brings clarity, depth, and clinical relevance to Elizabeth Torres’s groundbreaking Moving Sensing Perspective in autism. Drawing on her decades of experience in occupational therapy and neurodevelopmental work, Rosemary unpacks Torres’s rich, data driven research and translates complex concepts into practical understanding for clinicians supporting autistic children, adults, and their families. Rosemary bridges theory and practice by explaining how movement, sensation, and nervous system variability offer crucial insights into how autistic individuals experience and respond to the world. She reframes common clinical observations—such as differences in motor control, regulation, attention, and communication—through the lens of self-generated sensory feedback and lived physiological experience, moving beyond behavior-based interpretations. Throughout the talk, Rosemary emphasizes why this perspective matters for everyday clinical decision-making. She explores how understanding individual movement signatures can support more respectful assessment, reduce misinterpretation of intent, and guide interventions that prioritize regulation, safety, and autonomy rather than normalization or compliance. Case examples illustrate how this framework can deepen collaboration with families and empower clinicians to listen to what the body is communicating, not just what is observable on the surface. Objectives Participants will analyze the Movement Sensing Perspective to explain how movement, sensation, and nervous system variability shape the lived experiences of autistic individuals. Participants will interpret clinical observations—such as motor differences, regulation, attention, and communication—through the lens of self-generated sensory feedback rather than behavior-based assumptions. Participants will apply movement-informed assessment and intervention strategies that prioritize regulation, safety, and autonomy while enhancing collaboration with families. Rosemary White, OTR/L is from Australia and has been an Occupational Therapist since 1972. Rosemary received her Neurodevelopmental Therapy training in London with the Bobaths, her Sensory Integrative Therapy training in Los Angeles with Dr. A Jean Ayres and her training in DIR®/Floortime with Stanley Greenspan, MD and Serena Wieder, PhD and the Faculty of ICDL. Rosemary is the owner of a private practice and specializes in working with children presenting with challenges relating and communicating such as autism, sensory processing/integration differences and motor planning and regulatory/attention differences Rosemary’s practice emphasizes understanding the impact of the child’s sensory processing and postural control on their capacity to relate, communicate and learn.

< Back Sound and vision: How San Antonio is building inclusivity in arts and culture Nicholas Frank Dec 20, 2023 Sound and vision: How San Antonio is building inclusivity in arts and culture Anyone seeing the Classical Music Institute ’s presentation of Vivaldi’s Four Seasons the morning of Nov. 1 might have thought they were at one of the ensemble’s rehearsals. The atmosphere was casual, audience members chatted, snacked and sipped from sippy cups, napped under blankets, played with phones and tablets, got up and walked the hallways of the Tobin Center for the Performing Arts , fidgeted with toys, leaned in to listen to concertmaster Francisco Fullana’s comments on what to listen for in upcoming musical passages and otherwise came and went as they pleased. The public event was not a rehearsal, but the latest Valero Sensory Friendly Program performance geared toward audiences sensitive to the loud noises, bright lights, large crowds and extended sitting times typical of conventional performances. The keys to the series are inclusion and accessibility, said Kimberly Stephenson, the Tobin Center’s director of education. “It’s just a very open and welcoming environment,” Stephenson said. “We are wanting to expose everyone to the beauty and the power of the arts.” For anyone Sensory-friendly events are primarily designed to accommodate those with autism spectrum disorder who might have difficulties adjusting behaviors to social situations or communicating their needs effectively. Valero series accommodations include limiting the audience to half the standard size, keeping house lights on throughout the performance — which is limited to a one-hour duration — and encouraging patrons to talk or vocalize and move around freely. Noise levels are kept consistent so as not to startle or overwhelm with sound. For the Classical Music Institute sensory-friendly performance, Fullana frequently turned to the audience and spoke about the music they were about to hear, saying they should listen for birdsong-like passages played by the violin section and imagine a festive garden party signaled by Vivaldi’s famous melody. Jacqueline Ha brought her 2-year-old son Tiago to the performance in part because “he has a very keen ear for music.” The Tobin Center welcomes anyone to these free public events, and Ha and her partner recognize that though Tiago has not been diagnosed as on the autism spectrum, he has a short attention span and displays sensitivity to bustling crowds and loud sounds. The Four Seasons concert was the second Tobin Center sensory-friendly event they’ve attended, and Ha said they appreciate the accommodating environment. “Just the fact that we have exposure to performances at the Tobin is something that we’re really grateful for, as far as learning what parameters are conducive to him as a little being exploring himself,” she said. An invisible disability Other arts and culture organizations in San Antonio have offered sensory-friendly accommodations and specially designed events with similar modifications, in the name of inclusivity for audiences of all abilities. The San Antonio Zoo held a sensory-friendly version of its annual holiday Zoo Lights extravaganza on Nov. 20. What is normally billed as “miles of dazzling lights, festive music, and whimsical displays” was dialed down, tailored for those with sensory sensitivities. Music volume was muted by 80%, laser strobe lights were removed, other bright lights were dimmed and more sensory-friendly implement bags were made available. As with other institutions, the bags are available for free during visits at the information desk. Alex Rodriguez, the Zoo’s manager of diversity, equity and inclusion, described sensory sensitivity as “an invisible disability” that is more common than generally realized. She said thatwhen sensitivities beyond the autism spectrum are taken into account, including military veterans with post-traumatic stress disorder, individuals with dementia and even neurotypical adults who can become overwhelmed in overstimulating environments, “every community you are in, every family or social dynamic that you’re in, chances are somebody in that group has this [condition]” in one form or another. Everyone means everyone The Valero series at the Tobin defines its mission as “equitable services for the creative arts to promote justice, inclusion, and empowerment for all.” In a similar spirit, The Public Theater of San Antonio took Tiny Tim literally when the character intones “God Bless us, everyone” at the end of the Charles Dickens holiday classic A Christmas Carol . The theater company’s version of the play that ran Dec. 1-17 integrated deaf and hard-of-hearing actors, with a script adapted to shift between moments of speaking and moments communicated only through American Sign Language (ASL). The reworked script by Tim Hedgepeth and Anthony Ciaravino features a Scrooge, played by hearing actor John O’Neill, who learned sign language as a youth in love with a deaf woman and is moved to draw on his past to communicate with Tiny Tim, played by deaf actor Josiah Sammy Esqueda. The staging of the play aims to be as inclusive as possible and might help lend insight to hearing audiences into how deaf people communicate. “This production includes spoken word, moments of ASL, and supertitles,” said producing artistic director Jimmy Moore. “So we are communicating at any one point in two to three different ways.” The Public Theater has provided ASL nights since December 2015, said Robert Cardoza, founder of the Stage Hands sign language services company and assistant director of the production. But staging a play with a fully integrated deaf, hard-of-hearing and hearing cast is new, Moore said. Deaf actors, such as Missy Smith in the dual roles of Belle and Mrs. Fred, react to light cues rather than sound cues and interpret between sign language words and spoken words, which in some cases differ slightly. For example, she’ll sign “I finally accept you” while speaking “I at long last embrace you.” Moore said the play is just the beginning of such inclusive performances. “It is a really great first step for the Public to learn what it means to be more accessible to the deaf and hard-of-hearing communities in San Antonio.” Growing awareness While a 2016 Kronkosky Charitable Foundation report found San Antonio to be “an exceptional hub for autism services,” with a wide range of professionals who provide autism care, the report concluded that demand for services far outstrips supply. But Patty Vela, chief development and outreach officer of the nonprofit Autism Community Network , said accommodations such as sensory-friendly events are on the rise. Experts at the nonprofit including occupational therapist Adrienne Gaither have helped such local organizations as Morgan’s Wonderland and Methodist Hospital establish programs to welcome individuals with autism and other developmental disabilities. The Tobin Center’s sensory-friendly performances date back to the very start of its programming, Stephenson said, shaped in part by the help of the Autism Theater Initiative in New York and Kulture City, a nationwide organization that provides sensory-inclusive certification to venues interested in accommodating people with sensory needs. The DoSeum children’s museum researched Kulture City initiatives for its new Beyond Limits program, said program educator Shauna Brookins. Sensory-friendly Beyond Limits events take place after regular hours to limit crowds, with lighting dimmed and sound volumes lowered. Brookins plans four such events per year, with the next taking place Wednesday evening with a Winter Wonderland theme. The museum also provides sensory-friendly accommodations every day, Brookins said, with sensory backpacks that include headphones, sunglasses, fidget toys and a museum map that locates quiet zones including the Calm Corner, an enclosed, sound-dampened retreat room. Both Brookins and Vela encouraged parents to observe their children to detect areas of sensitivity, whether they shy away from loud sounds or avoid particular stimuli, or, as Ha said of her son, may simply need to get up frequently to walk around and burn off excess energy. “We’re first-time parents, we’re trying to learn how to meet him with where he’s at,” Ha said. And Rodriguez said she’s heartened by the growing awareness that many, if not most people, have some form of sensory sensitivity and that institutions are responding. She has auditory sensory sensitivities and visual impairments that make her sensitive to light, she said, and sometimes needs to walk away from stimuli to recuperate. “So for someone like me … coming into spaces like the [sensory-friendly] Zoo Lights [display] where the lights weren’t so overwhelming for me, it was much easier for me to enjoy that environment,” Rodriguez said. The next Tobin Center sensory-friendly performance is Pilobolus Is a Fungus , March 19 at noon. See the whole article with pictures here . Previous Next

< Back Teresa Camacho Medical Billing Manager teresa@acn-sa.org 210-435-9000

< 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

< Back RESPITE SERVICES About Respite Services Sometimes you need a break, we totally get it! Respite services provide short-term relief for families and caregivers of individuals with autism. Our resource library provides information on respite care options, including in-home and out-of-home services. PARENT’S NIGHT OUT / DAY RESPITE Artful Start Web: www.artfulstart.org E-Mail: artfulstart@gmail.com Artful Start organizes art programs for children with special needs throughout the community. Programs are run by trained volunteers with an adaptable curriculum to allow all participants to reach their maximum potential. Children’s Association for Maximum Potential (CAMP) —Teen and Adult Day Adventure 210.671.8112 Web: www.campcamp.org E-Mail: michelle.elble@campcamp.org Physical Address: 2525 Ladd St., Bldg. 3850, Lackland Air Force Base, TX 78236 Mailing Address: P.O. Box 27086, SA TX 78227 A supervised social program for teens and young adults with developmental disabilities, ages 14-40 (with no aggressive behavior); scheduled for one Saturday per month. Activities include dinner, movies, sporting events, concerts, and dances; teens may bring a date. Respite Club membership required. Mission Road Ministries - Mom’s Morning Out 210.334.2437 Web: missionroadministries.org/programs/children/moms-morning-out E-Mail: lbutler@mrmsat.org 8706 Mission Rd, SA TX 78214 Mission Road Ministries offers Mom’s Morning Out *each month. The program allows parents with children with intellectual developmental disabilities (IDD) some much deserved free time - even “me” time. This fun and important program is available to families living in San Antonio & Bexar County caring for a child with IDD. Tuition cost is $40/ child for 4 hours of care and must be between the ages of 6 thru 17. The program is from 9 AM - 1 PM. Program runs 1 Saturday per month and dates are on the website. Respite Care of San Antonio 210.737.1212 Web: www.respitecaresa.org 605 Belknap Pl., SA TX 78212 Families may bring their children (6 wks. To 17 yrs.) with special needs and medical complex conditions. Monday - Friday from 7:30am –6pm; non-disabled siblings (up to the age of 12) welcome. San Antonio Busy Bodies 210.545.2840 Web: https://www.sabusybodies.org/programs.html E-Mail: info@sabusybodies.org 11985 Starcrest Dr, SA TX 78247 Busy bodies is a learning center providing services for children including the development of fine and gross motor skills; balance; ocular motor control; attention span; self-esteem; and social skills. To qualify for the program; the child must attend an initial assessment for $200; in which the doctors determine what kind of treatment the child requires. The following therapy sessions are $35/hour. Busy bodies accepts some commercial insurance; but mainly private pay. Special Reach Inc 210.784.7478 Web: https://www.specialreach.com/ 6851 Citizens Pkwy suite #220 , San Antonio TX 78229 Party night is a Special Reach’s unique twist on Parent’s night out. It’s a great opportunity to develop social skills and meet other children aged 6-18. Additional summer program locations are available as well as new programs such as San Antonio Adventure Program. RESPITE CARE Mission Road Ministries - Respite Care 210.334.2437 Web: https://missionroadministries.org/lets-talk 8706 Mission RD, SA TX 78214 Children with Intellectual Disabilities have lived on the campus of Mission Road for nearly 65 years. We know what it takes to care for children who require individualized attention and constant supervision. At Mission Road we can provide your child with a weekend of fun and activity; while giving you the rest and relief you deserve. Your child will spend the weekend in one of our 5 cottages; interacting and playing with other children; all under the watchful eye of trained residential care professionals. A gymnasium; basketball court; sensory room; playground and Open Air Pavilion provide the backdrop for stimulating activities. A menu of meals and snacks carefully designed by our licensed dietitian are served family style. Our on- campus Health Care clinic dispenses any medications your child may need during their stay. Maxim Healthcare Services 210.341.3800 Web: https://www.maximhealthcare.com/ E-Mail: SanAntonioTX@maxhealth.com 7550 IH 10 West, Ste. 1001, SA TX 78229 Contact Person: Angela Barker, Business Development Manager Provides Private Duty Nursing, Companion services, respite care; Insurances accepted: Traditional Medicaid, Superior Medicaid, AmeriGroup, Molina, Blue Cross Blue Shield, Aetna, United Health Care, TriCare, Humana Military, Cigna, Care Centrix and most other insurances. Please, feel free to call the office should you need help with a funding source. Ramiro P. Estrada Respite Station - Children’s Hospital of San Antonio....210.704.3497 519 W. Houston, SA TX 78207 A respite program for families of children with developmental disabilities and multiple medical conditions; the program is available to children from birth to 18 years of age who require skilled car and medical support services. Respite Care of San Antonio 210.737.1212 Web: www.respitecaresa.org Davidson Respite House (DRH), 605 Belknap Place, SA TX 78212 Emergency/crisis facility dedicated to caring for children with special needs and complex medical conditions. Children may be placed at the DRH by their families so that they may attend to a crisis. Children are placed by the Texas Department of Family & Protective Services as a result of abuse or neglect; cares for children ages 0 to 17 years of age. The shelter is open 365 days per year, 24 hours per day. Previous Next

< Back STATE & FEDERAL SUPPORT About State & Federal Support State and federal support programs can be tricky to navigate. Thats why we have compiled a list of all the right places to call for options for individuals with autism and their families. Our resource library provides information on the different types of support available, including Medicaid waivers, social security benefits, and state and federal programs. STATE & FEDERAL SUPPORT Aging and Disability Resource Center (ADRCs) 855.937.2372 Web: https://hhs.texas.gov/services/aging/long-term-care/aging-disability-resource-center State Agency over Medicaid Waiver Programs like CLASS, HCS, and MDCP Texas Council for Developmental Disabilities 512.437.5432 Web: www.tcdd.texas.gov E-Mail: tcdd@tcdd.texas.gov 6201 E. Oltorf, Ste. 600, Austin TX 78741 Note: TCDD does not provide any direct services Texas Workforce Commission Vocational Rehabilitation Services 800-628-5115 Web: https://twc.texas.gov/jobseekers/vocational-rehabilitation-services Vocational and employment services, independent living services; Early Childhood Intervention is under this department; technology and resource center. Previous Next

< Back ADVOCACY About Advocacy Services Advocacy plays a crucial role in advancing the rights and needs of individuals with autism and their families. Our resource library offers information on community-based and social advocacy, including grassroots organizing, public policy initiatives, and community outreach. We also provide resources on educational advocacy, including strategies for navigating the special education system, securing appropriate educational services, and collaborating effectively with school districts. COMMUNITY BASED & SOCIAL ADVOCACY Disability Rights Texas Statewide Intake 512.454.4816 Web: www.disabilityrightstexas.org 222 W. Braker Ln., Austin, TX 78758 South Texas Regional Office 210.737.0499 6800 Park Ten Blvd., Ste. 208-N, San Antonio TX 78213 Intake hours are from 8AM -5 PM. Telephone number 1.800.252.9108 (Intake Specialist). Advocates for people with disabilities to secure their human, legal, and service rights, and assists them in advocating for themselves for these same rights. Strives to establish and expand rights and services for people with disabilities, to inform all individuals of the rights of people with disabilities, and to inform and refer individuals to programs and services. Texas Council on Developmental Disabilities 512.437.5432 Web: http://www.tcdd.texas.gov/about/governance/ E-Mail: tcdd@tcdd.texas.gov 6201 E. Oltorf, Suite 600, Austin, TX 78741-7509 T he DD Act provides for a Council to be appointed by the Governor of each state to serve as the governing board for the state’s developmental disabilities council. EDUCATIONAL ADVOCACY 101Advocacy 210.722.9974 Web: www.101advocacy.com Sylvia Farber: sfarber@101advocacy.com 101 Advocacy helps families navigate through the special education or 504 processes by educating families on special education/504 laws and their rights, collaborating with parents to get effective educational programs and services from school districts, reviewing the IEP to ensure it is written to meet individual student needs, and assisting at ARD/504 meetings. 101 Advocacy offers bi-lingual advocacy. Brighton Center - Special Education Support Services 210.826.4492 Web: www.brightonsa.org 14207 Higgins,SA TX 78217 265 E. Lullwood, SA TX 78212 SESS is a one-time 3-hour class that includes a meal, childcare, and a SESS Graduation Certificate with 3hr Credits. These are small group clinics designed to address concerns and questions about your child’s ARD/IEP. Please bring a copy of your child’s most current ARD/IEP document. Sessions held at various times and locations throughout San Antonio. Please call for more information. Eagles Flight Advocacy and Outreach 210.960.6635 Web: https://www.eaglesflightsa.com/ 26520 Fire Dance, Boerne, TX 78006 E-Mail: info@eaglesflightsa.com Advocacy provided for Special Education needs. Contact Pam Allen. Girasol Margain 210.826.4492 Web: www.BrightonSA.org Brighton Center, 265 E. Lullwood, SA, TX 78212 E-Mail: gmargain@brightonsa.org Special Education Advocate and Trainer Jennifer Fitzhugh 210.415.6098 E-Mail: jenniferlayne@sbcglobal.net Advocacy/Consulting-Advocacy for families who need ARD support; also, provide trainings for parents and professionals. Juan Hernandez 210.826.4492 Web: www.BrightonSA.org 265 E. Lullwood, SA TX 78212 E-Mail: jhernandez@brightonsa.org Special Education Advocate and Trainer Karla Calla 210.826.4492 Web: www.BrightonSA.org 265 E. Lullwood, SA TX 78212 E-Mail: kcalla@brightonsa.org Special Education Advocate and Trainer Lorene Dill 210.367.5710 Web: www.dillardadvocacy.com E-Mail: Lorene@DillardAdvocacy.com 6058 Crab Orchard, SA TX 78240 Provides consulting and training as well as advocacy services in all areas of special education. Able to attend ARD meetings with parents to help advocate for your Child’s rights; provides parents with information and training to increase their advocacy skills to make informed decisions regarding their child’s education. Partners Resource Network – Team Project – Region 20 409.898.4684 Web: www.partnerstx.org . 1090 Longfellow Dr, Beaumont, TX 77706 SA Independent Living Services (SAILS) 210.281.1878 Web: www.sailstx.org 1028 S. Alamo, SA TX 78210 SAILS provide information and assistance to people of all ages with disabilities and their families to access support systems and promote changes that result in full access to the community. SAILS can also provide information and education on the Americans with Disabilities Act and information on disability rights. Services are available to residents in 28 counties. You may call them for assistance Monday - Friday 8:00 AM to 5:00 PM and you do not have to have an actual doctor diagnoses to be assisted. The Legal Framework 432.561.4332 Web: framework.esc18.net/ Region 18 providing Statewide Leadership for the Legal Framework for the Child- Centered Process in Texas; In collaboration with the Division of IDEA Coordination at the Texas Education Agency; The resource page provides access to documents which are used in the Special Education Process. Special Education Support Services (SESS) 210.826.4492 Web: www.brightonsa.org 14207 Higgins, SA, TX78217 SESS is a one-time 3-hour class that includes a meal, childcare, and a SESS Graduation Certificate with 3hr Credits. These are small group clinics designed to address concerns and questions about your child’s ARD/IEP. Please bring a copy of your child’s most current ARD/IEP document. Sessions held at various times and locations throughout San Antonio. Please call for more information. Previous Next

< Back THERAPY RESOURCES Under Construction Previous Next