Categories
Treatment

State

And the truth is that I had been injured. I had been damaged. […] And I hadn’t wanted to be more autistic.

Most autistic people don’t want to hear [that certain microbial states are causally linked to behaviors characterized as autistic].

Many view it as a threat to the notion of neurodiversity as a phenomenon that has existed with unchanging frequency since the dawn of time […] Others fear it may fuel more abuse against autistic children. […] There is a very real basis for worrying that parents of [autistic] children might badly harm them in misguided attempts to ‘treat’ or ‘cure’ [them].

I imagine that if I had been born with the degree of autism I experience today, I wouldn’t view my newly limited state negatively, because I wouldn’t have experienced a loss.

Twilah Hiari

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It might seem like saying “we’ll do anything to help you” or “we tried everything” would make a kid feel like you really adore them, but this can actually make someone feel horrible. If you’ve always been disabled, disability doesn’t really feel like an emergency, nor does it really feel separable from who you are. So it can just feel, [if someone would be desperate enough to try everything], like you must be sort of a disaster.

Amanda Forest Vivian

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Doctors and researchers seem to think that curing cancer seems to be only a matter of time. My question is how we live in the meantime.

Out of context, Meredith Minister

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Categories
Treatment

Life

Life, in other words, is being made a condition of nonautism. And while life is always life, the condition of ‘life with’ autism comes to be immediately understood as a life that bears the origin of its own undoing. It is a life under threat and so is no kind of life at all. […] How, in other words, can advocacy live anything other than a (good, neoliberal, and necessarily nonautistic) life of fighting for – and so securing, attaining, recovering – the vital being of nonautism? How, when any alternative to the nonautistic life is so carefully and so thoroughly framed as not life at all?

Anne McGuire

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I interfere because I think you, and people like you, will benefit from hearing the perspective of the receiving end of those therapies and treatments. Because I think you should know red flags of abusive treatments. Because I think that you should be thinking about risks versus benefits, and what kinds of “benefits” are benefits you actually want, and what kinds of risks you’re willing to tolerate for what kinds of benefits.

I don’t want to call all the shots in your parent-child relationship. I want you to listen to those with relevant experiences – to me, to other autistic people, etc – and to think about what you’re doing. I want you to think about the potential consequences, about what’s best for your kid, and what is a true deal-breaker for you.

I want your generation to avoid making the same mistakes with your kids that my parents’ generation made with me. I want you to learn from their mistakes without having to repeat them yourself, and to make the best possible decisions for your kid.

And that’s why I “interfere.”

ischemgeek

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What is problematic in the drive for medical cure is its narrow, simple focus on the gains and benefits that cure may bring, disregarding its associated harms, risks, and disenabling effects.

It also closes off ways to support, in the present, ‘un-treated’ and ‘incurable’ lives, that is, people who have a disability or an illness, as well as people who refuse or cannot afford treatments. When bodies are pronounced ‘incurable,’ they are read as being in a condition of a ‘nonlife’ – without a future and denied meaning in the present. At the same time, cure denies a place for disability and illness as different ways of existing in the present. Cure discourses and imagery operate in political, moral, economic, and emotional realms that go beyond individual medical treatments and personal desires for remedy.

An emphasis on cure as the only path forward is damaging, because it obscures the fact that cure is always a multifaceted negotiation, often enabling and disabling at the same time, and may be accompanied by pain, loss, or death.

For many, cure demands that we suspend our living in the present and instead wait for a future without disabilities and illnesses, urging us to not live in the present.

Alison Kafer calls this temporal framing ‘curative time’:

“In our disabled state, we are not part of the dominant narratives of progress, but once rehabilitated, normalized, and hopefully cured, we play a starring role: the sign of progress, the proof of development, the triumph over the mind or body.”

[…]

Set against the impossibility of inhabiting the present, the promised transformation through cure is enticing enough to make losses and hastened death acceptable, even expected.

Kafer continues,

Within this frame of curative time, then, the only appropriate disabled mind/body is one cured or moving toward cure. Cure, in this context, most obviously signals the elimination of impairment but can also mean normalizing treatments that work to assimilate the disabled mind/body as much as possible.”

The curative drive also demands an approximation of normality through ‘habilitation’ (the acquisition of skills and abilities) and ‘rehabilitation’ (the regaining of skills and abilities that have been lost or impaired).

Eunjung Kim

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Categories
Treatment

Optimal

McGuire writes in more depth about the influence of capitalism in producing childhood and children as sites of ‘investment’ in potential futures (McGuire 2016 119-133). This in turn creates pressure for parents to produce optimal futures for their children by embracing interventions aimed at preventing, curing, or at least mitigating, disability (Carey, Block, and Scotch 2019).

In this conception of childhood, neuro-developmental disabilities, like autism, are constructed as an information-commodities. They are both a justification for clinical intervention, and a framework for understanding which interventions should be prescribed. In this process Autistic bodies and experiences are abstracted and objectified. Far from being an economic burden, Autistic people’s lives, and experiences of disability, become the grist that form the basis of an industry (Mallett and Runswick-Cole 2012; McGuire 2016, 126).

Manidoo Makwa Kwe

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I think therapy can be a great thing for kids, even a life-changing thing. What I object to is the attitude that all kids with disabilities need therapy, and they all need it from the start, and they all need as much as they can get.

Garden of My Heart

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Lovaas’s rhetorical construct of “recovery [to normalcy]” has proven to be so powerful and so culturally resonant for nearly 25 years […]

This explicit linking of the rhetorical construct of recovery [to normalcy] with a particular intervention methodology […] functions ideologically […] foregrounding and naturalizing the notion of ‘intervention’ as the only commonsense response

[…] Implicit in the testimony of both Carmen and Maurice is the assumption that one must do something upon coming to understand that one is the parent of an autistic child, one must intervene in some sort of active way, and that this intervention must involve changing or altering the child in some way.

The question considered by the parents above appears not to be whether to intervene, but rather, how to do so.

Alicia A. Broderick

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Categories
Treatment

Always

Being disabled doesn’t erase the need for down time. Being disabled doesn’t erase the need for play, or for connections to other people.

Ruti Regan

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Anyway… some questions… […]

1) How much time does this kid spend with adults who are in “therapy mode?” How does “therapy mode” look different from how these people would typically act?

2) What skills/behaviors are being targeted? How is the child’s behavior pathologized and controlled based solely on their diagnosis?

3) Is this positive reinforcement, or is this bribery? Is this positive support, or is this holding the world hostage until some sort of compliance is achieved?

4) Is the child really “motivated” or are they being subtly coerced?

5) How does the program address abuse and trauma? How do they commit to not perpetuating it?

6) How is this child segregated or othered from neurotypical peers? Are they expected to do things that realistically, neurotypical children don’t have to do? (An random example I often see is autistic students being taught they can never climb up a slide, even though in the real world, children do this all the time)

7) How is disability accommodated, and how aware are the practitioners of autism’s numerous comorbid clusters? Do they know what faceblindness is? How to recognize absent seizures? Will it cross their mind that their client might be “engaging in maladaptive behavior” because they have a migraine or gastrointestinal pain… or will they seek out other antecedents to blame?

8) Does this child *really* need intervention? Or do they just have a diagnosis and someone willing to put up money? I am not just talking about ABA, but speech, OT, etc. I can think of a lot of autistic adults who didn’t have ABA, but hated their speech therapy sessions. And they still stutter.

9) Is punishment used?

10) Most ABA places will want to know what motivates (reinforces and punishes) the student. But… what motivates the practitioner? Remember, these people want your money, and often have Savior Syndrome to boot.

11) What does the kid think?

12) What is the professional culture and hierarchy like? For example… Can newer therapists question superiors? Are people aware of ethical/accountability reporting processes? Do the “good therapists” just ignore the bad ones?

Meredith K Ultra

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It works because it doesn’t assume; it works because it outwardly claims no value system, other than application of scientific learning principles in naturalistic environments.

But like any valueless system of applied study, its values are many.

Melanie Yergeau

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They are not rejected for their difference, but brought closer.

Practitioners trip over themselves to call it a “science of learning.”

Its surveillance isn’t only (hideously) remarkable for its capacity to observe, chart, and narrate individual acts […] at root it espouses ideologies and technologies of normalization.

It is in a fact a science of regulation and social control.

Not a refusal to recognize them, but an insidious desire to acquire knowledge of them.

Christine Skolnik, Melanie Yergeau

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