Showing posts with label Healthcare. Show all posts
Showing posts with label Healthcare. Show all posts

 https://www.newsweek.com/dual-approach-autism-opinion-1818062

To drive true progress and improve the quality of life of all autistics we need BOTH Strengths_based_Opportunities AND Challenges_based_Solutions. 
It is not Either-Or.





#Autism #Research #Strengths_based_opportunities #Challenges_based_solutions.

Apr 7 is World Health Day

Its the day the WHO was founded in 1948. 

Urgent need to step up to the healthcare needs of autistics. 

Biomedical research is a CRITICAL part of this solution. 


Health Care Considerations

April is Autism Solutions Month. 

Some Healthcare Considerations

Autistic and other high-support disabled people often need full sedation to access procedures like regular dental care, yet such procedures are rarely covered by insurance—which means people aren't getting the care they need, says @HariSri108.

Another medical care consideration from @HariSri108 is that often autistic people cannot tolerate the sight of medical implements like syringes. Providers can take simple steps like covering implements with towels until they are actually used.





Benzodiazepines and Barbiturates



Benzodiazepines

In class today, we studied pharmacology of GABA-A receptors, specifically Benzodiazepine's. Of personal interest as I've been on lorazepam (fast acting for agitation, mood swings) and clonazepam (longer lasting). Unfortunately the body develops a tolerance and these don't work anymore.

Incoming Lambda

Not enough that we have a delta variant causing grief the world over. 

And now there a Lambda variant which is slowly creeping in. 

Image Source news-medical.net

A Thank you to Healthcare Workers around the world

From 6 Countries and 14 languages comes this tribute to healthcare workers around the world from the Sacramento based WeEmbrace and founder Meena Kalayanasundaram

Happy to have played tiny role in this compilation


My tiny bit

https://youtu.be/6gbMqJhSYi4


Crip Camp Conversations: Disability Leaders Respond to Coronavirus




The Best Audience Chat Comment undoubtedly was
"I feel like my life will now be measured as “pre this talk” versus “post this talk”. Thank you for this!" 

Amazing experience being on the panel for this webinar. Glad to be able to add value to this very important issue. 


I got several requests to share what I'd "talked" about in the webinar. 
Here are the slides and transcript of audio. 

Introduction 



Image Description. Young Indian American male sitting in front of a laptop. Black hair. Wearing a cap and T-shirt that say Berkeley.

Hi everyone. Thank you for having me here. My name is Hari Srinivasan. I’m a non speaking autistic. I type to communicate. I have a bunch of other challenges like oral-motor apraxia, ADHD, OCD, anxiety etc. 

I’m a student at UC Berkeley with a major in psychology  and minor in disability studies. 

This is my third semester as student instructor for a faculty sponsored semester long class on autism. I think of it as a way to change awareness in the way 30 students each semester will come to view disability and autism in their future lives. A majority of the students are non-autistic and able-bodied. We had a very interesting discussion on autism and covid-19 just two weeks ago. 

I’m also a student journalist for the Daily Californian. I get to write about many disability related issues which have included a column on autism. My two recent articles focused on social distancing and on healthcare issues surrounding the disability community during this pandemic. If you google my name and Daily Cal you should find links to these articles. 



I joined the board of ASAN, the Autistic Self Advocacy Network earlier this year. 

As the pandemic unfolded ASAN has really been working with other disability orgs to advocate for our civil rights. An early area was medical rationing, the combined advocacy has lead to non discrimination directives at various levels. But we have to continue to be vigilant that this is translated to in the field. 

ASAN is also branching out now to work on issues like making sure people who need a support person can bring their family member or communication partner with them if they are hospitalized, even if the hospital has a no visitors policy, as a reasonable accommodation under the americans with disabilities act. As a person with high support needs, this is an area close to home for me. 

In terms of home and community based services, ASAN is pushing very hard for the next covid bill to include emergency grants to service providers so that people can be supported in their homes, and to keep people from ending up in congregate settings. To make that possible, support people need personal protective equipment and higher pay, as well as emergency child care and paid leave. Some agencies need to hire more folks and rearrange how they provide services etc. ASAN is also tracking infections, hospitalizations, deaths from covid-19, of people with disabilities living in congregate settings, because we know those settings are so much deadlier than a person's own home. 

Several disability orgs, including ASAN, are partners on the #WeAreEssential social media campaign, which lays out a lot of these issues along with others.

Issues facing Students and Families during this time

Hari, we know covid19 has had a great impact on students and families. Can you tell us about student responses or your thoughts on this?



I’ve been informally polling other peer autistics and their families to find out their challenges. And, as an autistic with high support needs, I experience many of these issues myself as well. 

To start with, this pandemic is kind of like a waiting game filled with endless uncertainty and anxiety. If the abled bodied population themselves are having increasing mental health issues, it’s a multiplier effect on the disabled population. I’m hearing that even kids under 10 are getting prescribed antidepressants. 

In autistics this uncertainty and anxiety can also manifest in so many different ways. There has been a huge increase in all kinds of maladaptive behaviors, whether it's meltdowns, obsessive compulsive behaviors, aggression, self-injurious behavior, disturbances in sleep patterns and other things that add to the already stressful times. 

It's the disruption or even lack of access to support services, therapies and education itself. The remote education model or tele therapy does not work for many who need that physical one on one support and have other needs. I want to quote one parent who says that “only certain people with certain needs qualify for tele therapy.”  Students  who are transitioning between the school and adult programs, like one of my friends, are stuck in limbo with no help at all.  

Many autistics had been working on building independence in community based skills or social interaction skills. Many don’t have the same access to the outdoors or nature hikes as before even for physical exercise. 

Even prior to the pandemic, we as a community have experienced a great deal of social isolation and stigma; this lockdown has given it a frightening face.  Lack of these critical supports, therapies and social opportunities will mean a regression in skills for autistics. 

At the same time, many other skills and behaviors have to be un learned for the current time, such as shaking hands or holding the door open for others. Then there is other hygiene issues - autistics with impulse control issues find it hard to not touch surfaces or maintain a six feet distance. 

Even for those who are able to avail of some form of remote instruction, whether at school or college level, there are big time gaps between the classes, with basically nothing to do. While some have figured out ways to cope, others find this to be very isolating and suffocating. One of my peers says he is “super duper frustrated.”

A bright spot is that some autistics are enjoying remote instruction, where you are free from social interaction pressures. I can just mute my zoom to cut off my stemming noises. Keeping up with social expectations can be exhausting for autistics. 


Wearing a mask has presented another challenge as many autistics have sensory issues. 

Every autistic has a different set of challenges and things that calm or work for them.
 It takes time for families and other caregivers to figure these out. Those with higher support needs rely on caretaker familiar with their needs. During this pandemic the caregiver role defaults to the immediate family for many autistics.  What happens if those caregivers fall ill or if the individuals themselves fall ill. Will healthcare workers even know what to do, how to handle our “behaviors” and other unique needs?. 

Autism is wide spectrum which means that many have health co-morbidities, like seizures and gut conditions. Even during non-pandemic times, many of these go undiagnosed. How will doctors even begin to treat us. 

Many of us will need our support person with us if we need to be isolated or hospitalized. It is a scary thought to imagine being alone in a hospital. I am so happy ASAN, Communication First and other orgs are working on this issue,  That support people be not just be allowed to accompany us, but also be provided the PPE protective gear. 

Some of my peers have needed hospitalization for other issues during this time, which can be absolutely un nerving. 

 I can’t even begin to articulate the plight of autistics who are in group residential settings, especially the larger ones.They like nursing homes for the elderly, are sitting ducks. 



Now for another perspective.  I mentioned earlier that we had discussed autism and covid at the autism class at U C Berkeley for which I am a student instructor. A majority of the class are able-bodied students. What really struck me was the lack of awareness on the part of the non-disabled community. Some of the student responses in my class - from surprise to shock is so telling.  Here are a couple of sample reactions. 

“This entire pandemic is making me absolutely sick about how the disability community is being treated. Dehumanized and devalued. It’s not fair, it doesn’t make any sense”

“The disregard for people with autism, or any intellectual disability, by hospitals in the time of covid 19. It is saddening to see, especially when it is in direct noncompliance with the Americans with Disabilities act.”

“Something that surprised me was how people on the spectrum are being treated throughout covid 19. It actually makes me so upset that people need just as much medical attention as those that are being affected. Just because we are having a pandemic does not mean the normal life things just suddenly stop.”

The point I want to make by showing you these student reactions is that we need to work even more vigorously on awareness of these issues in the mainstream community to bring about change. We need even more allies in the non disabled community. Only then will change be easier and can happen. The current scorched earth scenario is laying bare all the inadequacies of the system. This is like a shocking wake up call of sorts.

What gives me hope

What is giving you hope or resiliency right now?



I am in awe, of the fierce advocacy efforts being done by organizations and individuals to keep our civil rights alive by making noise and lobbying and widely publicizing our issues. We need to make a lot more noise.

This time of need has also given way to so many random acts of generosity and kindness.
An example is the many different online free classes that have sprung up to help us through this hard time. I am able to try out new classes and am no longer limited by having to travel to a remote location amid traffic  to try these things.

Our new normal has meant that many of what we thought had to be social norms are no longer applicable. You don’t have to sit in a cubicle from nine to five to be able to hold down a job for instance. You can turn off the camera or the mic on your zoom if you want. You can choose to be heard and seen. 

I am also encouraged at how greener our earth is getting in just such a short span of time. Just cutting down traffic can have such a huge impact on our air quality. It gives me much hope that we can do something about climate change. And with people in lockdown, the animals are finally getting to enjoy the outdoors in peace which is again telling of their oppression. 

I am in deep admiration that many in the disabled community are not just helping out each other during this time but also participating in the greater community good, like making masks for healthcare workers.

Our strength of character and resilience is shining through. And that gives me so much hope for now, and the future.

A Call to Action

We have enough time for each panelist to make one call to action.



This has been a tremendous wake up call of sorts for all of us.

 I'll keep this call to action very short with ASAN’s big ask right now. 

We really really need people to call, to email, to tweet your congressperson, and demand funding for home and community based services. 
autisticadvocacy.org/2020/03/action-alert-covid19-relief/



Additional Audience Chat Comments
Fantastic insights indeed Hari. Thank you so much for sharing
Thank you Hari - great insights!
Thank you Hari for your positive words of hope.
Great insights Hari. 




How Unconscious and Conscious Bias Affect Autistics

In PlainSpeak, Plain Language for the Lay Reader 


In our journey towards a fair and inclusive society, it's important to understand the different types of biases that affect how we think about and treat people, especially those with autism. Bias can be divided into two main types: implicit (unconscious) and explicit (conscious) bias. Both play big roles in keeping unfair treatment and inequality going.

Implicit Bias

Implicit bias, also known as unconscious bias, refers to the automatic and unintentional thoughts or stereotypes we have about certain groups, even if we don't realize it. These biases are deep in our subconscious and can affect our actions and decisions without us knowing. For example, someone might unknowingly associate certain racial groups with negative traits, even if they believe in fairness and equality.

Impact on the Autism Community

For people with autism, implicit biases can show up in different ways:

  • Healthcare: Doctors might unknowingly underestimate the pain or discomfort that autistic people feel, leading to poor care or wrong diagnoses. These hidden biases can result in less effective healthcare for autistic individuals (van Ryn & Fu, 2003).

  • Education: Teachers might not expect as much from autistic students, which can hurt their chances to learn and succeed. This could mean keeping autistic students in separate special education classes instead of including them in regular classes, or treating them differently in the classroom, affecting the quality of their education.

  • Employment: During hiring, employers might overlook autistic candidates, even if they are qualified for the job. This keeps unemployment rates high among autistic adults and limits their ability to be financially independent.

Recognizing and dealing with implicit bias is crucial for promoting diversity, fairness, and inclusion in all parts of society. Tools like the Implicit Association Test (IAT) can help people discover their hidden biases, so they can work on reducing them in their actions and decisions.

Explicit Bias

Explicit bias, on the other hand, is when people deliberately hold prejudiced views or discriminate against specific groups. Unlike implicit bias, explicit bias is clear and recognized by the person who holds these beliefs. For example, someone who openly says negative things about people of a certain ethnicity is showing explicit bias.

Impact on the Autism Community

Explicit bias against autistic individuals can take many forms:

  • Hate Speech and Discrimination: Autistic people might face obvious discrimination or bullying at school, work, or in social settings. This can lead to feeling isolated, anxious, and depressed.

  • Discriminatory Policies: Explicit biases can shape policies that hurt autistic people. For example, not providing the right support or accommodations in schools or workplaces can limit their opportunities.

  • Stigma and Stereotyping: Explicit biases keep harmful stereotypes about autism going, like the idea that autistic individuals can't contribute meaningfully to society. These stereotypes can hurt their self-esteem and mental health, making it harder for them to fit in.

Addressing Bias in Autism

Understanding and addressing both implicit and explicit biases is important to create a fairer and more inclusive society for autistic people. Here are some steps we can take:

  • Education and Awareness: Teaching people about autism and the biases that affect autistic individuals can help reduce both types of bias. Campaigns and programs can challenge stereotypes and promote understanding.

  • Policy and Advocacy: Supporting policies that help the rights and needs of autistic people is essential. This includes making sure they have access to good healthcare, education, and job opportunities.

  • Training and Development: Training professionals in healthcare, education, and other fields to recognize and deal with their biases can lead to fairer treatment and better outcomes for autistic individuals.

  • Community Engagement: Involving the autism community and listening to autistic voices in decisions can make sure their needs and perspectives are included. This helps build a society where autistic individuals are valued and respected.

Implicit and explicit bias

In the quest for a more equitable and inclusive society, it is crucial to understand the different forms of bias that influence our attitudes, beliefs, and behaviors toward individuals or groups, particularly those with autism. Bias can broadly be categorized into implicit (unconscious) and explicit (conscious) bias, both of which play significant roles in perpetuating inequality and discrimination. 

Implicit Bias

Implicit (unconscious) bias, refers to automatic and unintentional attitudes or stereotypes that individuals hold about certain groups, even when they are unaware of these biases. These biases are deeply ingrained in our subconscious minds and can influence our actions and decisions without conscious awareness. For example, a person may hold implicit biases that lead them to associate certain racial groups with negative traits or behaviors, despite consciously believing in equality and fairness.

In the context of autism, implicit biases can manifest in various ways:

  • Healthcare: Healthcare providers might unconsciously underestimate the pain or discomfort expressed by autistic individuals, leading to inadequate care or misdiagnosis. Implicit biases can affect clinical judgments and patient interactions, often resulting in suboptimal healthcare outcomes for autistic individuals (van Ryn & Fu, 2003).

  • Education: Educators might unconsciously hold lower expectations for autistic students, impacting their educational opportunities and achievements. Implicit biases can lead to autistics kept in segregated special education rather than mainstreamed or differential treatment in the classroom, affecting the quality of education that autistic students receive.

  • Employment: Implicit biases in hiring processes can result in autistic candidates being overlooked for job opportunities, despite having the necessary qualifications. This perpetuates high unemployment rates among autistic adults and limits their economic independence. 

Recognizing and addressing implicit bias is essential for promoting diversity, equity, and inclusion across all areas of society. Tools such as the Implicit Association Test (IAT) can help individuals identify their unconscious biases, enabling them to take steps toward mitigating these biases in their interactions and decisions.

Explicit Bias

Explicit (conscious) bias, on the other hand, is deliberate prejudice or discrimination against specific groups of people. Unlike implicit bias, explicit bias is readily recognized by the individual holding these beliefs. For instance, an individual openly expressing discriminatory attitudes or engaging in discriminatory behaviors toward people of a certain ethnicity demonstrates explicit bias.

Explicit bias against autistic individuals can take many forms:

  • Hate Speech and Discrimination: Autistic individuals might face overt discrimination or bullying in social, educational, or workplace settings. This can lead to increased social isolation, anxiety, and depression among those affected.

  • Discriminatory Policies: Explicit biases can influence the creation and implementation of policies that disadvantage autistic individuals. For example, policies that do not provide adequate accommodations in schools or workplaces can limit the opportunities available to autistic people.

  • Stigma and Stereotyping: Explicit biases contribute to the perpetuation of harmful stereotypes about autism, such as the belief that autistic individuals are incapable of contributing meaningfully to society. These stereotypes can negatively affect the self-esteem and mental health of autistic individuals and hinder their social integration.


Addressing Bias in Autism

Both implicit and explicit biases are important to understand and address to promote a more equitable and inclusive society for autistic individuals. Here are some steps that can be taken:

  1. Education and Awareness: Raising awareness about autism and the biases that affect autistic individuals can help reduce both implicit and explicit biases. Educational programs and campaigns can challenge stereotypes and promote understanding and acceptance.

  2. Policy and Advocacy: Advocating for policies that support the rights and needs of autistic individuals is essential. This includes ensuring access to appropriate healthcare, education, and employment opportunities.

  3. Training and Development: Providing training for professionals in healthcare, education, and other fields can help them recognize and address their biases. This can lead to more equitable treatment and better outcomes for autistic individuals.

  4. Community Engagement: Engaging with the autism community and including autistic voices in decision-making processes can ensure that their needs and perspectives are considered. This promotes a more inclusive society where autistic individuals are valued and respected.

By understanding and addressing both implicit and explicit biases, we can work towards a society that is truly inclusive and equitable for all individuals, including those with autism.

References

  • van Ryn, M., & Fu, S. S. (2003). Paved with good intentions: Do public health and human service providers contribute to racial/ethnic disparities in health?. American Journal of Public Health, 93(2), 248-255.
  • Project Implicit. (n.d.). About the IAT. Retrieved from Project Implicit