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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

Sensory Safety: Fostering Relationships to Support Social-Emotional Development in Children Time AM Breakout Session - 10:00 AM Presenter/Facilitator Dr. Carrie Alvarado, PhD, OTR, PACT Accredited Provider and PACT UK Associate Adrienne T. Gaither, OTR, C-SIPT, C/NDT, PACT Accredited Provider Back to Course List < Back About the Course This session explores how sensory and relational safety work hand-in-hand to form the foundation of emotional wellbeing and learning readiness in children. Participants will gain an understanding of how neurodevelopmental differences can impact sensory processing and increase vulnerability to sensory trauma, often affecting a child’s ability to feel safe, connected, and regulated. Through a trauma-informed and developmentally appropriate lens, attendees will learn actionable strategies—such as coregulation, responsive caregiving, and predictable routines—that promote both sensory and relational safety, supporting deeper social-emotional growth and resilience in all learning environments. Objectives Participants will define sensory and relational safety and describe their interconnectedness in creating a foundation of wellbeing and learning readiness in children. Participants will explain the foundational neurodevelopmental differences that can impact sensory processing and create a vulnerability for sensory trauma, influencing a child’s ability to feel safe and connected in various contexts. Participants will apply trauma-informed, developmentally appropriate strategies that buffer these vulnerabilities and support sensory and relational safety through predictable routines, coregulation and responsive caregiving. Dr. Carrie Alvarado, PhD, OTR, PACT Accredited Provider and PACT UK Associate Adrienne T. Gaither, OTR, C-SIPT, C/NDT, PACT Accredited Provider Dr. Carrie Alvarado is the Chief Operating Officer of Autism Community Network (ACN) and holds a PhD in Infant and Early Childhood Development with a focus on Infant Mental Health and Developmental Disorders. She is the creator and director of the Earliest Connections Clinic, which provides early diagnosis and therapeutic intervention for high-risk infants and toddlers, and she leads ACN’s DIRFloortime and PACT programs, offering intensive, dyadic coaching through in-vivo and reflective video feedback. Her research centers on sensoriaffective integration, attachment, and the optimization of parent-mediated interventions via telepractice; she developed the Sensoriaffective Interactional Attunement Scale (SAIAS) and is currently working on the Emotional Intelligence and Praxis in Play Scale (EIPPS). Dr. Alvarado was the first accredited PACT practitioner in the U.S., serves as an Associate with PACT UK, and is a DIR®Floortime™ Certified Expert Clinician and Assistant Faculty for the Profectum™ Foundation. She has held leadership roles with STAR Institute, Fielding Graduate School of Psychology, and UT Health’s OTD Program. Carrie is a passionate innovator and connector, deeply committed to empowering families and clinicians alike. She is also the proud mother of three daughters, wife of 24 years, devoted animal lover, Huberman Lab fan, and a proud family member to several beautifully neurodiverse relatives who continue to inspire her work and life. Speaker Disclosure: Dr. Alvarado receives a salary from Autism Community Network. Adrienne Gaither, Chief Program Officer at Autism Community Network (ACN), is a licensed pediatric occupational therapist with over 25 years of experience supporting children and families. A graduate of The University of Texas Health Science Center at San Antonio, Adrienne has practiced in nearly every pediatric OT setting and has served as a vital member of ACN’s team since 2009. She is a Pediatric Autism Communication Therapy (PACT) Accredited Practitioner and a core part of ACN’s interdisciplinary diagnostic team, using a strengths-based, neurodiversity-affirming lens to support children’s development. Adrienne holds specialty certification in the Sensory Integration and Praxis Tests (SIPT), has advanced training in Neurodevelopmental Treatment (NDT), and played a key role in the development of Morgan’s Wonderland, particularly in designing the park’s Sensory Village. In addition to her work at ACN, she serves as a Program Director and Sensory Consultant for Kinetic Kids, Inc., a local nonprofit offering sports and recreation to children with special needs. Outside of work, Adrienne enjoys time with her husband, two children, and two dogs, as well as running, singing, and traveling. Speaker Disclosure: Ms. Gaither receives a salary from Autism Community Network.

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

Caregiver Empowerment. At Autism Community Network, we know the best way to connect with others in the autism community is through fun and play! We offer a variety of programs designed for the whole family. Our Caregiver Empowerment Program aims to fortify the entire caregiver system with kindred relationships and critical knowledge to improve the overall wellness of your family. 02 SibShops SibShops are fun and energetic events that celebrate the many contributions made by brothers and sisters of autistic children. Participants will meet other neurotypical siblings of autistic children while having fun, laughing, and connecting on all aspects of having an autistic sibling. SibShops combine information and discussion activities with fun, high-energy games, food activities, and arts and crafts. SibShops are distinguished from general recreational programs by implementing discussion activities in each session. Discussion activities allow neurotypical siblings a safe space to share their own experiences while a facilitator actively listens and validates their feelings. Sibshops events are typically 2-4 hours long and may have 5-10 participants in each group. They are currently held once per month on the ACN campus. SibShops are designed for school-age children and seek to provide siblings with opportunities for peer support within a fun, recreational context that emphasizes a kids view. We believe that brothers and sisters have much to offer one another if given a chance. SibShops are our commitment to the well-being of the family member most likely to have the longest-lasting relationship with the autistic child. This program is generously supported by Circle Bar Foundation. 01 Camp AUsome! Camp AUsome! provides summer programming for autistic children and their siblings. From play-based camps to learning to code, our camps have it all! Click the link below for more information. Read More 03 Fam Jams ACN's Quarterly Fam Jams are sensory-friendly, neurodiversity-affirming community celebrations for the whole family. We will provide the food, music, and fun. All we need to complete the party is you and your loved ones. For information on our upcoming parties, please follow our event calendar and/or social media. Registration is required. If you or your organization is interested in volunteering at a Fam Jam, please email Katie Benson at katie@acn-sa.org. 04 Caregiver Ambassador Program Each family receiving an autism diagnosis has a different emotional experience. Some families would like a person with lived experience to take their hand as they embark on this new pathway. Our Caregiver Ambassador Program (CAP) connects families new to the autism community with seasoned caregivers. Together, both families can grow in knowledge and lean into each other along their journeys. For more information, follow the link below. Read More 05 Parent Groups Autism Community Network takes pride in offering a range of support groups tailored to the diverse needs of our community. We understand that individuals and families navigating the world of autism and neurodiversity often require different forms of support and guidance. Two of our prominent support groups are the PACT Parent Empowerment Pod (P-PEP) and the Neurture Project, each designed to provide specialized assistance to caregivers at different stages of their journeys. The PACT Parent Empowerment Pod (P-PEP) is an invaluable support group aimed at parents who have already participated in our PACT program. PACT equips parents with essential skills and knowledge to better support their child on the autism spectrum. Following their completion of PACT, parents may find themselves in need of continued support and connection with peers who have shared similar experiences. P-PEP serves as a lifeline, offering a supportive community where these parents can share insights, challenges, and triumphs, fostering a sense of empowerment and resilience. The Neurture Project is another vital support group specifically designed for caregivers of infants and toddlers, including those born during the challenging times of the COVID-19 pandemic. The early years are critical for neurodiverse children, and the Neurture Project recognizes the unique needs and concerns that caregivers face during this period. Our support group provides a nurturing space where caregivers can connect, share experiences, and access valuable resources to navigate the uncertainties of raising neurodivergent infants and toddlers, especially in the context of a global health crisis. Both P-PEP and the Neurture Project exemplify Autism Community Network's commitment to providing tailored support that meets the evolving needs of individuals and families affected by autism and neurodiversity. We believe that through these support groups, we can empower caregivers with knowledge, camaraderie, and resilience, fostering a stronger and more inclusive community for all.

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

:Le Brunch des Chapeaux Raffle Items Package #1 Beauty Package Parkhurst Luxe Medical Spa | Morpheus 8 Sugar & Lash | Lash Treatments HOTWORX | One Month Membership Heights IV | Treatment Skin Atelier | Laser Treatment & BBL Moxy Kelly Wade | Gift Card RFSA | Hydrafacial & Botox LOMI | Lomi Beauty Products & Bespoke Facial Jordan & Peterson | Gloz Deluxe Facial & Assorted Products Valued at $8,100 123-456-7890 info@mysite.com Package #2 Men's Package Bader Ranch | Dove Hunt for 8 People Dury's Gun Shop | Gift Card Origins Spa | $1,500 Laser Hair Removal Minx & Onyx | Vintage Whiskey Glasses & Matching Ice Bucket with Tongs New Braunfels Smoke House | Gift Card Chestnut Farms Bottled in Bond Bourbon (750mL) Valued at $5,100 123-456-7890 info@mysite.com Package #3 Staycation - San Antonio Sol Cypress Hotel | 1 Night Stay Elsewhere | Elsewhere Experience Bistr09 | Gift Card St. Bernard | Gift Card Penny Lane | Gift Card Majestic Theatre | Diana Krall Tickets Blü Prime Steakhouse | Gift Card The Alamo | Exhibit Tickets Citrine Home | Gift Card San Antonio Museum of Art | 4 Day Passes Valued at $2,800 123-456-7890 info@mysite.com Package #4 Family Package San Antonio Zoo | Tickets and Swag Alamo Heights Pool | Season Passes for up to 6 Immediate Family Members Farnsworth Orthodontics | Adolescent Orthodontic Treatment (Total Complexity) The Tobin Center for the Performing Arts | 6 Tickets to Ninja Kids, July 2025 Fiesta Texas | 4 Day Passes DoSeum | 1 Year Family Membership Valued at $7,500 123-456-7890 info@mysite.com Package #5 Andrea in Austin, Texas The Moody Center | Andrea Bocelli VIP Tickets - June 13, 2025 - Soundcheck Included! (Donated by Tobin Center for The Performing Arts) Shetler Fine Jewelers | Gift Card Ten Ten Restaurant |Gift Card Devil May Care | Gift Card J. McLaughlin | Handbag Valued at $4,000 123-456-7890 info@mysite.com Package #6 Afterparty Charlotte Dawson | Assorted Wines 2015 Moet ‘Grand Vintage’ Extra Brut Rosé Champagne NV Billecart-Salmon ‘Reserve’ Brut 2021 Alphonse Mellot ‘Le Paradis’ Sancerre 2023 Far Niente Chardonnay Napa Valley 2021 Frank Family ‘Reserve’ Chardonnay Carneros 2018 Grieve Family Sauvignon Blanc Napa Valley 2017 Kistler Vineyards ‘Dutton Ranch’ Chardonnay Russian River Valley 2022 Kosta Browne Pinot Noir Russian River Valley 2022 PlumpJack Merlot Napa Valley 2022 Caymus ‘50th Anniversary’ Cabernet Sauvignon Napa Valley 2019 Conn Creek ‘Special Selection’ Cabernet Sauvignon Napa Valley 2017 Beringer ‘Steinhauer’ Carbernet Sauvignon Howell Mountain Valued at $2,000 123-456-7890 info@mysite.com Purchase your Tickets at the Event Other Day of Opportunities Join us in celebrating and supporting the important work that Autism Community Network is doing by participating in one of the other amazing "Day Of" Opportunities at Le Brunch des Chapeaux including an incredible Silent Art Auction sponsored by AnArte Gallery and Ana Montoya. See below for more information! Silent Auction Art Piece by Ana Hernandez-Burwell Ana Hernandez-Burwell holds a BFA in painting, with a minor in Art History from the University of Texas in San Antonio. She exhibits her work regionally and internationally. Ana has worked on numerous public art projects in San Antonio and Tamaulipas, Mexico. Fractured images of femininity, pop culture, and regional icons populate Ana Laura Hernández’s paintings. Born and raised on the South Texas border, Hernández-Burwell draws from her experience as a first-generation American and mother in contemporary culture. Hernandez lives and works in San Antonio, Texas. Ana will be painting an art piece on 28x48 canvas at the event that can be curated based on the winning bidder's preference. (Estimated value: $6,000+) You can see more of Ana's beautiful work here . Silent Auction Art Piece by Taylor Bohné Taylor Bohné is a mixed media, visual artist who was born and raised in San Antonio, and partially Southern Florida. He is inspired by Florida tropical landscapes, and modern Latin and Mexican American that is prevalent in the San Antonio Chicano and Modern art movement. His paintings focus on unique San Antonio architecture and iconic business storefronts to show appreciation and pride for his San Antonio roots. Follow Taylor on Instagram to see more of his incredible work. Taylor will be painting an art piece on 18x24 canvas at the event that can be curated based on the winning bidder's preference. (Estimated value: $2,500+) You can see more of Taylor's talent here . Present Pick Lee Michaels Fine Jewelry Purchase a present from Lee Michaels Fine Jewelry which is guaranteed to contain at least a $100 value! You may win one of the following: $2,000 Gift Card $500 Gift Card $100 Gift Card A Piece of Jewelry Each chance costs $100, and there is over $15,000 in prizes available. Take a look at some of their beautiful jewelry here . Plus! All proceeds benefit Autism Community Network and the amazing work they do for autistic children and the people who love them. Paddles up! Signature Raffle: A Julian Gold Experience This year, Le Brunch des Chapeaux is proud to introduce The Signature Raffle as part of our annual paddle raise in support of Camp AUsome! Guests who donate $1,000 or more will receive a signature Le Brunch des Chapeaux tote and one entry into The Signature Raffle. This exclusive prize package includes a gift card from Julian Gold, a gift card from Christine A. Moore Millinery, and select items from the Zimmermann Line. Your generous support provides neurodivergent children with access to a summer of connection, learning, and joy—while also giving you a chance to win something extraordinary.

Make Referral If you observe early signs of autism or developmental differences in your patients, we're here to help. Submit a referral using the button below to connect families with supportive, neurodiversity-affirming services. Click Here Why Refer to ACN Specialized Early Childhood Diagnostics ACN is dedicated to providing expert care for our families. Our physician, clinicians, and educators have 228 years of combined experience in supporting autistic and/or developmentally different children and families. They provide interdisciplinary and comprehensive play-based evaluations for children ages 0-5. Families who come to ACN receive same-day results and personalized recommendations that are tailored to the specific needs of the entire family. Neurodiversity-Affirming & Trauma-Informed Care ACN is guided by our Experts by Experience Board , a growing group of autistic adults who assure that our practices are in alignment with neurodiversity-affirming care and are responsive to the expressed needs of the community we serve. We work hard to build environments and relationships that feel safe and that honor different kinds of minds. At ACN, we believe that every child has gifts to give and deserves to be understood strengths-based lens. Family-Centered Care At ACN, we believe that parents are the experts in their children. Families are involved every step of the way. We tailor our diagnostic and therapeutic experiences to the specific needs and motivations of each child and family. Our innovative and evidence-based therapies are parent-mediated, which means they empower families! We invite families to join our “herd” through involvement in quality-of-life programs, including SibSHOPS, FAMJAMS, Caregiver Support Group, and Coffee and Connections. Families involved with ACN have a sense of COMMUNITY and a place to call HOME. Mission-Driven, Outcome-Focused As a nonprofit, at ACN our priority is clinical excellence and lasting impact- not profit. Our clinical, educational and quality of life programming is dedicated to creating long-term positive outcomes, or BIG Futures, for the children and families we serve. Our mission is to create a community that recognizes and celebrates the value of our neurodiverse community members and understands the role we can all play in creating an inclusive world. When to Make a Referral This downloadable guide helps providers recognize early signs of autism in young children, including social communication differences, repetitive behaviors, and sensory preferences. It’s also designed to be shared with families—offering clear, compassionate language to support understanding and early action. Use it as a reference tool and a conversation starter for timely referrals to ACN. Download Guide Resources for Families Help families access the full range of ACN’s supportive services—from diagnostic evaluations and quality of life programs to community events and caregiver trainings—by connecting them to our team today. Refer a Family

Events coming up. Featured Event ACN Fall Summit 2025 Toward Neuroharmony: A Different Way of Seeing and Supporting Autism Date: October 3, 2025 Time: 7:30 AM - 4:30 PM Location: The Tobin Center for the Performing Arts 100 Auditorium Circle San Antonio, TX 78205 Info: Email info@acn-sa.org for more information. Get Started All About ACN Summit Autism Community Network’s annual Summit returns for 2025 with the theme “Toward Neuroharmony: A Different Way of Seeing and Supporting Autism.” This full-day conference invites families, educators, clinicians, and community partners to explore strengths-based, neurodiversity-affirming approaches to care and connection. This year’s keynote speaker is internationally renowned author and researcher Dr. Barry Prizant, PhD, CCC-SLP, presenting on topics from his groundbreaking book Uniquely Human and offering deep insight into echolalia and gestalt language development. Participants will also engage in specialized breakout sessions tailored for caregivers, educators, and clinicians, and hear directly from autistic voices during the Experts by Experience Panel. More upcoming events. June 16-20 July 7-11 July 21-25 Camp AUsome! WE:PLAY Join us for our first camp of the summer, WE:PLAY! This play-based camp focuses on building communication, regulation, and social skills. Camp AUsome! WE:ACT Our FIRST ever Camp WE:ACT for autistic middle and high-schol students interested in musical theater. Campers will learn and perform scenes and songs from Disney favorites! Camp AUsome! WE:GO Our only camp for neurotypical/allistic siblings. This week-long camp takes place in Copano Bay, TX along the Gulf Coast where campers spend there time learning to do all kinds of fun things! Let's Get Social