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< 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.

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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

Caregiver Ambassador Program (CAP) ACN offers a Caregiver Ambassador Program designed to connect new and more practiced autism caregivers. Through the program, participants are able to share resources, discuss best practices, and learn from each other’s experiences. This program provides support, guidance, and education to families who are new to autism caregiving. Additionally, it helps experienced caregivers stay up-to-date with the latest research and advancements in autism care. 02 What do I ask my ambassador? Feel free to ask you ambassador anything you think might help. If you are unsure about where to go to sign up for Medicaid waiver programs, or if you need help with finding a great place for haircuts, our CAP's will share with you what has worked best for them and other resources they may have heard about. All CAP's are familiar with ACN's services and can get you to the right place if they don't have an answer. 01 How CAP works. The Caregiver Ambassador Program pairs families new to our herd with caregiver volunteers of our organization. The program helps give families and caregivers a friend who has experienced similar circumstances, successes and struggles and is further along on their autism journey. 03 What else do ambassadors do? CAP's are volunteers for the organization and may be found representing our ACN family at special events and resource fairs handing out swag and educational/promotional information. CAP's are leaders of the herd, families who have a special passion to support other autism families in any way possible. How to start: Contact our CAP Team. Autism Community Network wants to pair you with the right ambassador. Whether you are a grandparent, father or mother, we have someone who can keep it real with you, guide you to real answers, and celebrate real victories! Request An Ambassador

Does my child have autism? To know for sure, you should have your child screened . We do offer both screenings and diagnostics. Getting Started in 3 Easy Steps 1) Watch this video These are characteristics of children on the autism spectrum compared to children who might have developmental delays. Can you identify the differences? 2) Know the signs Our friends at Autism Navigator have created a pretty great checklist that details the signs to look out for in your child. Bring these behaviors up to your child's doctor if you notice more than one or two of them. View Checklist 3) Give this form to your child's doctor. If you are done with steps 1 and 2 and noticed several similarities in your child's behavior it is a good idea to schedule an appointment with your child's pediatrician. Below is a referral form for them to fill out so that we can schedule a screening. Download Form Our Services Get Support for Your Autism Journey at Autism Community Network Explore

< 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

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 EDUCATION About Education Services Our education resources provide information on evidence-based interventions and educational programs designed for individuals with autism. These resources can help families find appropriate educational settings and interventions that can help individuals with autism succeed in school and beyond. HIGHER EDUCATION Northwest Vista College – Access Office 210.486.4466 Web: https://www.alamo.edu/nvc/academics/resources/access-disability-services/ CCC204, 3535 N. Ellison Dr., SA TX 78251 E-Mail: nvc-access@alamo.edu Contact: Sharon Dress, Coordinator Our Lady of the Lake University Students with Disabilities Office 210.431.4010 Web: www.ollusa.edu Sueltenfuss Library, Room 125, 411 SW 24th St., SA TX 78207 E-Mail: nomonsibais@ollusa.edu Contact: Nicole Monsibais, ADA Coordinator Disability services and tutoring Palo Alto College – Disability Support Services 210.486.3020 Web: https://www.alamo.edu/pac/admissions-aid/disability-support-services/ Palomino Center, Room 116, 1400 W. Villaret, SA TX 78224 Contact: Cindy Morgan, Coordinator –Student Success E-Mail: cgibbs3@alamo.edu Contact: Greta Rodriguez, Sr. Generalist – Student Success E-Mail: grodriguez405@alamo.edu San Antonio College – Disability Support Services 210.486.0020 Web: https://www.alamo.edu/sac/about-sac/college-offices/disability-support-services/ Moody Learning Center, Room 1 Floor, 1819 N. Main Ave., SA TX 78212 Contact: Jennifer Alvizo, Director E-Mail: jalvizo2@alamo.edu Contact: Patricia Sanchez, Advising Team Leader E-Mail: pgorentz@alamo.edu St. Mary’s University 210.436.3011 Web: https://www.stmarytx.edu/campuslife/student-services/accessibility/ One Camino Santa Maria, SA TX 78228 E-Mail: stmudsts@stmarytx.edu Welcome to St. Mary’s University’s Disability Support Services. St. Mary’s University ensures effective access to its programs, services and activities for all qualified individuals with documented disabilities. Effective access is accomplished through a variety of accommodations and services tailored to meet each individual student’s strengths and unique needs. Disability Support Services ensures access; the student supplies the success. Trinity University – Student Accessibility Services 210.999.7411 Web: https://www.trinity.edu/directory/departments-offices/student-accessibility-services Halsell Center, Ste. 201, One Trinity Place #85 , SA TX 78212 E-Mail: sas@trinity.edu University of Texas at San Antonio (UTSA) Student Disability Services 210.458.4157 Videophone: 210.591.7318 Web: www.utsa.edu/disability One UTSA Circle, Rm. 3.01.16 Multidisciplinary Studies Building (MS), San Antonio, TX 78249 E-Mail: disability.services@utsa.edu Contact: Dr. Dianne Hengst, Director Student Disability Services or Stacy Mason, Associate Director University of the Incarnate Word – Student Disability Services 210.829.3997 Web: https://my.uiw.edu/sds/ Administration Bldg., Rm. 105, 4301 Broadway, CPO #286 , SA TX 78209 MUSIC Dreams Fulfilled Through Music 210.771.5809 Web: www.dftm.org Contact: Mary Kathryn Archuleta, Executive/Artistic Director E-Mail: dftm.alamoangels@gmail.com P.O. Box 1233, Helotes, TX 78023 Adaptive Music Therapy/Music Therapy/Performance Opportunities. For all ages. SCHOOLS (K-12) The Achievers Center for Education 210.690.7359 Web: https://www.achieverssatx.org/ University United Methodist Church, 5084 De Zavala Rd., SA TX 78249 A secondary school for children 6th-12th grade who are two or more years behind grade level in any academic area; accepts students with and without disabilities and learning differences; features a low student-teacher ratio and hands-on teaching methods. Brighton Center 210.826.4492 Web: www.brightonsa.org 14207 Higgins RD., SA TX 78217 Child Development Center: 265 E. Lullwood, San Antonio, TX 78212 Throughout San Antonio and Bexar County, Brighton Center provides developmental and educational services to children of ALL abilities. With a holistic, family-centered approach, we offer enrichment and development through an inclusive early childhood education program, as well as therapy services, counseling, case management and special education support & services. Clowvazar Academy 210.690.4800 Web: www.clowvazar.com 12746 Cimarron Path #120 , SA TX 78249 The Clowvazar Academy is a year-round alternative education school for Kinder through 12th grade. Our staff works with children who are Special Ed, General Ed and Gifted-and-Talented. We take students with anxiety, high-functioning autism, dyslexia, ADHD and other similar learning differences. We have a large General Ed population. During the summer, we also offer an affordable summer school program. FEAST (Home School Support) 210.342.4674 Web: https://homeschoolfeast.com/ 7735 Mockingbird Lane, San Antonio, TX 78229 The Foundation School for Autism - San Antonio 210.402.0253 Web: https://www.foundationschool.net/ 2235 Thousand Oaks, Ste. 130, SA TX 78232 The Foundation School for Autism is a public charter school for autistic children ages 3-7 with a focus on early intervention. Tuition is FREE. Kim's Learning Solutions, LLC 979.236.5286 Web: http://kimslearningsolutions.com/contact-us/ E-Mail: bilikimcornwell@gmail.com 16007 Via Shavano, Suite 102, San Antonio, TX 78249 Learning solutions that address both the strengths and the needs of the individual Private tutoring and assessments/evaluations. One for Autism Academy 210.680.8737 Web: www.oneforautism.com 1216 W. Ave., SA TX 78201 One For Autism, Inc. was established to serve children, youth and adults of all levels of functioning while providing a comprehensive individualized program, aimed at enhancing language and communication, social, play, academic, and independent living skills. Public School Education Service Center Region 20 Education Service Center 210.370.5200 Web: www.esc20.net 1314 Hines Ave., SA TX 78208 Contact: Janet Enriquez 210.370.5381 Region 13 Education Service Center 512.919.5313 Web: www.esc13.net 5701 Springdale Rd., Austin TX 78723 Sunshine Cottage School for Deaf Children 210.824.0579 Web: www.sunshinecottage.org 603 E. Hildebrand, SA TX 78212 A private, non-profit, accredited school for both hearing impaired children and hearing children. Children with hearing loss are taught to listen and talk through the use of digital hearing aids or cochlear implants. The Newborn Hearing Evaluation Center is a diagnostic testing site for newborns: insurance and Medicaid accepted. The Parent Infant Program (birth to three) is available, at no cost, for parents with hearing impaired infants and toddlers. Weekly sessions, parent support groups, nurturing classes, Family and Me Outings, in-home visits and free audiological services are part of this program. Full-day classes encompass State standards with integration of technology in the curriculum, placing emphasis on developing oral-language skills. Classes have a low student-to-teacher ratio of 7:1 and begin with three-year old’s through the fifth grade, combining children with hearing loss and children with typical hearing; generous scholarships available. SCHOOL DISTRICT AUTISM PROGRAM CONTACTS Bexar County Alamo Heights ISD 705 Trafalgar, SATX 78216 210.442.3700 Director: Kris Holiday www.ahisd.net East Central ISD 6634 New Sulphur Springs Rd. SA 78263 210.648.7861 Director: Mary Eitinear & Nina Pugh www.ecisd.net Edgewood ISD 900 S. Eduardo, SA 78237 210.444.8103 Director: Jose Hinojosa www.eisd.net Harlandale ISD 12121 S E Loop 410., SA 78221 210.989.5250 Director: Della Taylor www.harlandale.net Judson ISD 8205 Palisades, SA 78233 210.945.5348 Director: Theresa Arocha-Gill www.judsonisd.org Lackland ISD 2460 Kenly Ave., Bldg. 8265,SA 78236 210.357.5042 Director: Hans Palmer www.lacklandisd.net Military ISD Co-op (Ft. Sam, Lackland, Randolph Field) 3921 Bowley, SA 78234 210.368.8771 Director: Hans Palmer https://www.fshisd.net/ North East ISD 8961 Tesoro Dr., Ste. 500, SA 78217 210.407.0185 Director: Carol Bushnell www.neisd.net Northside ISD 5651 Grissom Rd., SA 78238 (210) 397-8742 Director: Krista Garcia www.nisd.net San Antonio ISD 1702 N. Alamo St., SA 78215 210.225.2406 Director: Kristen E. Williams www.saisd.net Schertz-Cibolo- Universal City ISD 200 W. Schlather St. Cibolo, 78108 210.945.6426 Director: Kim Williams www.scuc.txed.net Somerset ISD PO Box 279, Somerset 78069 1.866.465.8828 Director: Ramiro Nava https://www.sisdk12.net/ South San ISD 5622 Ray Ellison Blvd. SA 78242 210.977.7250 Director: Julie Silva www.southsanisd.net Southside ISD 1460 Martinez-Losoya Rd., SA 78221 210.882.1600 Director: Kendal Olah www.southsideisd.org Southwest ISD 11914 Dragon Ln., SA 78252 210.622.4355 Director: Robert Robinson www.swisd.net Atascosa County Charlotte ISD (Atas- McMull Co-op) 831 Stadium Dr., Pleasanton 78064 830.569.1355 Director: Linsey Pawelek Jourdanton ISD (Atas- McMull Co-op) 831 Stadium Dr., Pleasanton 78064 830.569.1355 Director: Linsey Pawelek www.jourdantonisd.net Lytle ISD PO Box 745, Lytle 78052 830.709.5128 Director: Robby Pierce www.lytleisd.com Pleasanton ISD (Atas- McMull Co-op) 831 Stadium Dr., Pleasanton 78064 830.569.1355 Director: Keri Cooper www.pisd.us Poteet ISD (Atas- McMull Co-op) 831 Stadium Dr., Pleasanton 78064 830.569.1355 Director: Linsey Pawelek https://www.poteetisd.org/ Tilden ISD (Atas- McMull Co-op) 901 River St., Tilden 78072 1.361.274.2000 Director: Linsey Pawelek Bandera County Bandera ISD PO Box 727, Bandera 78003 830.796.6210 Director: Patricia Galm www.banderaisd.net Medina ISD One Bobcat Ln, PO Box 1470, Medina 78055 830.589.2851 Director: Sarah McCrae www.medinaisd.org Dimmitt County Carrizo Springs Consolidated ISD 300 N.7th St Carrizo Springs 78834 830.876.3503 Director: Michelle Howard www.cscisd.net Frio County Dilley ISD (Spec Ed Co-op 12) 318 Berry Ranch Rd., Pearsall 78061 830.334.8007 x1132 www.dilleyisd.net Pearsall ISD (Spec Ed Co-op 12) 318 Berry Ranch Rd., Pearsall 78061 830.334.8007 x1132 www.pearsallisd.org Kendall County Boerne ISD 123 W. Johns Rd., Boerne 78006 830.357.2098 Director: DeNette Krawczynski www.boerne-isd.net Kerr County Center Point ISD PO Box 377 Center Point 78010 830.634.2171 Director: Jeanie Zirkel www.cpisd.net Hunt ISD PO Box 259, Hunt 78024 830.238.4893 Director: Cindy Lambert www.huntisd.org Ingram ISD 510 College St., Ingram 78025 830.367.4630 Director: Dan Curran www.ingramisd.net Kerrville ISD 729 Tivy St., Kerrville 78028 830.257.2203 Director: Dan Wittle www.kerrvilleisd.net Kinney County Brackett ISD (Cluster5 Spec Ed Co-op) 308 N. Piper Ln., Uvalde 78801 PO Box 586, Brackettville 78832 830.988.2341 Fax: 830.988.2366 Director: Martha Posey www.brackettisd.net La Salle County Cotulla ISD (Spec Ed Co-op 12) 318 Berry Ranch Rd., Pearsall 78061 830.334.8001 Director: Alicia Rumfield https://www.cotullaisd.net/ Maverick County Eagle Pass ISD 587 Madison St., Eagle Pass 78852 830.758.7023 Director: Delia Gonzalez www.eaglepass.net Medina County D’Hanis ISD (Cluster 5 Spec Ed Co-op) 308 N. Piper Ln., Uvalde 78850 830.988.2341 Director: Martha Posey www.dhanisisd.net Devine ISD 1225 W. Hwy. 173, Devine 78016 830.851.0881 Director: Valerie Dykstra www.devineisd.org Hondo ISD 2608 Ave. H, Hondo 78861 830.426.5902 Director: Cynthia Gann https://www.hondoisd.net/ Medina Valley ISD 8449 FM 471 S. Castroville 78009 830.931.2243 Director: Dr. Lonna Clinch www.mvisd.com Natalia ISD PO Box 548, Natalia 78059 830.663.4416 Director: Leticia Buenrostro www.nataliaisd.net Real County Leakey ISD (Cluster 5 Spec Ed Co-op) 308 N. Piper Ln, Uvalde 78801 PO Box 2119, Lakey 78873 830.988.2341 Director: Martha Posey https://www.leakeyisd.net/ Uvalde County Knippa ISD (Cluster 5 Spec Ed Co-op) 308 N. Piper Ln, Uvalde 78801 PO Box 99, Knippa 78870 830.988.2341 Director: Martha Posey Nueces Canyon ISD PO Box 118, Barksdale 78828 Director: Martha Posey www.nccisd.net Sabina ISD (Cluster 5 Spec Ed Co-op) 308 N. Piper Ln. Uvalde 78801 PO Box 338, Sabinal 78881 830.988.2341 Director: Martha Posey https://www.sabinalisd.net/ Utopia ISD (Cluster 5 Spec Ed Co-op) PO Box 880, Utopia 78884 830.988.2341 Director: Martha Posey www.utopia.net Uvalde ISD PO Box 1909, Uvalde 78802 830.591.4928 Director: Victor Baron https://www.ucisd.net/ Wilson County Floresville ISD (Wilson Co Co-op) 908 10th St., Floresville 78114 830.393.5300 Director: Clint Askins www.fisd.us La Vernia ISD 13600 US Hwy. 87 W. La Vernia 78121 210.779.6600 Director: Brenda Oates https://www.lvisd.org/ Poth ISD (Wilson Co Co-op) PO Box 250, Poth 78147 830.484.3390 Director: Marissa Ximenez https://www.pothisd.us/ Stockdale ISD 503 S. 4th St., Stockdale, 78160 830.996.3551 Director: Lori Homeyer www.stockdaleisd.org Zavala County Crystal City ISD 805 E. Crockett St. Crystal City,78839 830.374.2367 Director: Melissa Guerrero www.crystalcityisd.org La Pryor ISD PO Box 519, La Pryor 78872 830.365.4004 Director: Rick Rodriguez www.lapryor.net SEX & RELATIONSHIP EDUCATION Planned Parenthood of San Antonio 210.736.2262 Web: www.plannedparenthood.org Offers free one-on-one information sessions for individuals with special needs. There are 5 locations in the area; some clinics based on income and family size. Accepts a variety of insurance plans and payment methods. Work with state and federal programs to help cut down costs for those who qualify. Shannon Criswell Peck - Counseling/Sex and Relationship Ed 210.826.9599 3030 Nacogdoches Rd. SA TX 78217 Practices Traditional Counseling for Families; & Individuals; Sex Therapy & Counseling; and Forensic Sexual Evaluating & Court Testimony. She’s a certified Sex Counselor who works with individuals with Autism who may live at home with parents or in a group home. Accepts most insurance plans and the office will answer any questions about insurance, fees, co-pays, etc. SOCIAL SKILLS TRAINING Cindy Constanzo LLC 210.421.8048 8603 Crownhill, #25 SA TX 78209 We have years of experience in the area of assessment and special education with a special emphasis on the individuals with social communication deficits such as those with Asperger’s Syndrome, Autism Spectrum Disorder, Attention Deficit Disorder and/or anxiety disorders. Cindy Constanzo’s services include an adult group; speech language communication assessment; autism assessment; parent support; and social communication therapy groups of 4th/5th grade, middle school and high school groups of 3-4 students. Please call or message to enroll or visit our website for a full listing of our services and credentials. We are glad to meet you in person or discuss by phone any questions you may have. Dr. Jodi Gonzalez Arnold 210.260.3948 14603 Huebner Rd Bldg. 6, SA TX 78230 Specializes in Clinical Psychology and Behavioral Health and accepts Medicare. Starfish Social Club 210.303.4433 Web: www.starfishsocialclub.org E-Mail: admin@starfishsocialclub.org 1117 Patricia Dr., SA TX 78213 Social groups, academic support, and summer camp for students of all ages with learning differences, including autism spectrum disorders, ADD/ADHD, learning disabilities, Down Syndrome, developmental delays, etc. Stone Oak Therapy Services 210.798.2273 Web: www.stoneoaktherapy.com E-Mail: stoneoaktherapy@gmail.com 1020 Central Pkwy. South, SA TX 78232 Contact: Claudia Goswitz, MA, Med, CCC-SLP This training consists of small groups of 3-6 children for social training and parent networks in order to provide strategies to develop connections among children of similar profiles and establish networks or friendships. Social group training is provided by Stone Oak Therapy Services and Learning Institute. SPECIALIZED TEACHING PRODUCTS Blue Cat PIES 210.547.3015 Web: www.bluecatpies.com Email: sales@bluecatpies.com A specialized line of supplemental learning activities specifically designed for students with autism. Activities are hand-assembled by adults with disabilities. Activity books are interactive and do not require handwriting to use. Blue Cat PIES is a product developed and produced by the Any Baby Can Autism Services Program staff. Proceeds benefit families receiving free services at Any Baby Can. TUTORING & LEARNING SUPPORT Feast Bookstore 210.342.4674 Web: https://homeschoolfeast.com/ Email: staff@homeschoolfeast.com 7735 Mockingbird Lane, San Antonio, TX 78229 The FEAST Bookstore has been around for decades and has many types of home school curriculum available. Should the situation arise that the store doesn’t have an item in stock; the friendly staff are always ready to assist you to make sure you get the products you need to successfully homeschool your children. Kim's Learning Solutions, LLC 979.236.5286 Web: kimslearningsolutions.com E-Mail: bilikimcornwell@gmail.com 16007 Via Shavano, Ste. 102, San Antonio, TX 78249 Learning solutions that address both the strengths and the needs of the individual Private tutoring and assessments/evaluations. LearningRx - San Antonio Northeast: 1270 N Loop 1604 E Ste. 1302, SA TX 78232……….210.960.8296 Northwest: 6222 De Zavala Rd #203 , SA TX 78249……………...210.920.7785 Web: www.learningrx.com They are here to assist those with cognitive skills training (Brain Training). They offer these programs to all that are at least 4 years old and up to 94 years old (just must be verbal). The programs are anywhere from 12 to 40 weeks. It is all private pay and it is $90 an hour with the average being 4 1/2 hours a week. They do have payment options that vary depending on the program that is selected. TOBII Dynavox Assistive Technology 800.344.1778 Web: www.tobiidynavox.com We make touch based and eye controlled computers and solutions for special education that help individuals with motor and speech impairments lead richer and more independent lives. Previous Next

< Back Pediatric Autism Communication Therapy Improved Long-Term Child Outcomes Catherine Aldred Mar 27, 2023 Despite Autism being an enduring condition affecting 2% of people globally, evidenced intervention to improve the developmental impairments is limited. Paediatric Autism Communication Therapy (PACT) is currently the only scientifically evidenced early social communication intervention to demonstrate long-term improved child social communication outcomes into middle childhood. The PACT intervention has shown long-term improvement of autism core symptoms within randomised clinical trials (RCTs). PACT relatively low-intensity approach is referenced in UK national guidance for the new autism care pathway from pre- to post-diagnosis and education support. The evidence base Within the NICE recommendations for intervention and support for autistic development in early childhood, only two interventions met the evidential criteria set by NICE for inclusion.PACT was one of these (the other was JASPER). These two therapies were described as “social communication interventions” and their evidence was the basis for the NICE recommendation to services to consider social communication intervention for autism intervention. Both these therapies work with parents or teachers, and have evidence to improve autistic children’s social engagement, adaptation, communication, and in the case of PACT, autism symptoms. No other therapies were considered to have evidence of effectiveness. Recent independent reviews (e.g. Sandbank et al 2020) have reached similar conclusions. These findings should therefore guide evidenced commissioning of services in autism. How does Paediatric Autism Communication Therapy work? Parents or caregivers are guided through the six steps of PACT by a certified professional using video feedback techniques delivered in 12 alienate week sessions for six months and monthly maintenance sessions for a further six months. Caregivers send a video of a 10-minute interaction or play with their child to the therapist before each video feedback session. PACT builds on existing skills by sharing and analysing the best video clips identifying new strategies and techniques, summarised in an individual written programme for 30-minute daily practice between sessions. How is PACT different from other interventions? PACT has some unique distinguishing differences from other parent-mediated interventions. Firstly, it is the only intervention to use effective video- feedback methods with parents and caregivers and to use them within a modern developmental science-based model to optimise the social communication environment for the neurodivergent child. Secondly, PACT is the only intervention that has shown long-term sustained effectiveness in high-quality clinical trials in improving child autism outcomes for six years after the end of intervention. The Paediatric Autism Communication Therapy Trial An RCT of PACT delivered pre-school demonstrated significant endpoint effects to reduce symptom severity on ADOS Calibrated Severity Score (CSS) and ADOS-2 total algorithm score (Pickles et al. 2016; Carruthers et al. 2021). At follow-up, six years after the endpoint, treatment effects on child symptoms, adaptive outcomes, and child initiations with a parent were significantly sustained (Pickles et al. 2016). Furthermore, a mechanism study of the long-term impact identifies the ‘active processes’ by which interventions achieve their effects and provides insights into causal processes in development. PACT Trial Methods: Of 152 children randomised to receive PACT or treatment as usual between 2-5 years of age, 121 (79.6%) were followed 5-6 years after the endpoint at a mean age of 10.5 years. Assessors, blind to the intervention group, measured Autism Diagnostic Observation Scale Combined Severity Score (ADOS CSS) for child symptoms and Teacher Vineland (TVABS) for adaptive behaviour in school. PACT Trial Results: The treatment effect on child dyadic initiation with the caregiver (Dyadic Communication Measure for Autism, DCMA) was sustained through the follow-up period. Increased child initiation at the treatment midpoint mediated the majority (73%) of the treatment effect on follow-up ADOS CSS. A combination of midpoint child initiations and the direct effect of treatment also mediated the near- significant effect on follow-up TVABS. PACT Implementation The scalability of early evidence-based intervention is a global health priority. A not-for-profit social enterprise IMPACT CIC (Interaction Methods for Paediatric Autism Communication Therapy), established in 2017, disseminates PACT through a cascading ‘train the trainer’ model and implementation trials. Implementation trials test the feasibility, cultural acceptability and equal easy access to PACT in different contexts, including middle and low- economic settings. PACT video feedback methods are ideally adapted to online videoconference implementation. Pilot testing of online PACT has proved acceptable, feasible and accessible to families; further large-scale trials are in progress. Conclusions: Early social communication intervention can improve child social engagement with long-term generalised outcome effects on developmental. One thousand professionals have received PACT training, cascading PACT in twenty-six countries with six international implementation trials. Implications for autism services PACT is universally acceptable and feasible for implementation in different countries and cultures, enhancing autism care pathways from early identification and pre-diagnostic to post-diagnostic and education support. PACT training is available for professionals with appropriate training and qualifications and a minimum of two years of experience in autism. Please visit the website www.pacttraining.co.uk for more information on PACT training. Previous Next

< 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