Showing posts with label Therapy/Interventions. Show all posts
Showing posts with label Therapy/Interventions. Show all posts

 "Everyday moments of awe offer profound benefits to our mental health, enhancing personal well-being as well as a sense of belonging, at no expense. Unlike the price-gouging therapies we autistics are surrounded by since childhood, these experiences of awe are accessible and deeply meaningful." - Hari Srinivasan

Read on... https://www.liebertpub.com/doi/10.1089/aut.2024.38246.pw

 "When you say positive psychology in the context of autism, what comes to mind immediately is the image of people with autism thriving and flourishing, and moving beyond surviving. It boils down to that! We need to see real solutions that help autistics achieve a quality of life that goes beyond mere existence." - Hari Srinivasan 

Read on... https://www.liebertpub.com/doi/10.1089/aut.2024.38246.pw

Autism Space seen as profit making space by Private Equity

 Autism Space seen as profit making space by Private Equity

This is a continuing and troubling trend in autism. 

'...private equity investments per year tripled or quadrupled from 2018 to 2021 compared to 2015.

 ...expected investment to continue at breakneck speed

“...They needed to start showing profits and revenue that match their valuation. … So at some point, [investors] need to start seeing a return on their investment,”

 ...autism therapy space could be at the point of the investment life cycle where investors are pressuring operators to shift from scale to efficiency and profitability.

...opening clinics that reach targeted patients while being “financially healthy,” Marsh said. 

https://bhbusiness.com/2022/07/22/why-the-massive-investment-in-autism-companies-created-a-ticking-timebomb/

When basic social inclusion is a non-starter, what kind of thriving and flourishing are we talking about.

"Positive psychology must also recognize the needs of the most marginalized in the autism community, such as those with high support needs who face significant communication, health, and behavioral challenges. Even basic social inclusion is a non-starter for a good chunk of such autistics. For instance, parents of neurotypical children might have concerns about their children around an autistic child who may be aggressive or have self-injurious behaviors. Another example is a young adult I know who is homebound, with a worker who comes once a week and sits outside the house so that the parent can run errands. Such autistics are excluded even from segregated adult day programs meant for autistics. So, what kind of thriving and flourishing of autistics are we talking about here?" - Hari Srinivasan 

https://www.liebertpub.com/doi/10.1089/aut.2024.38246.pw



Neurotypical standards of Happiness

 "Danger of misunderstanding and misrepresenting the autistic community, with interventions possibly imposing neurotypical standards of happiness that feel inauthentic or unrelatable." - Hari Srinivasan 

https://www.liebertpub.com/doi/10.1089/aut.2024.38246.pw



High Cost of Positive Psychology Services is a Barrier.

"Integrating Autism and the Positive Psychology fields faces significant barriers, starting with the high cost of therapy, which automatically makes it inaccessible to a large portion of autistics and their families. Being autistic already comes with a big financial cost." - Hari Srinivasan 

https://www.liebertpub.com/doi/10.1089/aut.2024.38246.pw



 

How Your Posture Can Influence Your Emotions - Tips for Autistics

 

How Your Posture Can Influence Your Emotions -  Tips for Autistics

Did you know that the way you sit or stand can impact how you feel? Research by Peper and Lin (2012) has shown that adopting certain body positions can significantly influence your emotional state. For example, sitting upright can boost your mood and energy levels, while slouching can make you feel more down or even depressed.

Why This Matters for Autistics

For many autistics, understanding and managing emotions can be a unique challenge. However, becoming aware of how body posture affects feelings can be a simple yet effective tool for emotional regulation.

Here’s how posture can help:

  • Boost Mood: Standing or sitting up straight can naturally elevate your mood and increase your energy levels.
  • Manage Emotions: When feeling anxious or low, adjusting your posture to a more upright position can help improve your emotional state.
  • Easy to Implement: This strategy doesn’t require any special equipment or training. Just being mindful of your posture can make a difference!

Quick Tips to Try:

  • Check Your Posture: Throughout the day, notice if you’re slouching. Straighten up to see if it changes how you feel.
  • Practice Mindfulness: Engage in activities like stretching or gentle yoga to improve body awareness and posture.
  • Encourage Awareness: Have people around you check in on you and perhaps gently remind you about posture as a tool for emotional management. 
By paying attention to your body position, you can take control of your emotional well-being in a simple and effective way. Give it a try and see how a small change in posture can make a big difference!




Peper, E., & Lin, I. (2012). Increase or decrease depression: How body postures influence your energy level. Biofeedback, 40(3), 125-130.- They found that an upright posture can promote a more positive mood and energy levels, while a slumped posture can lead to increased feelings of depression.

Disability is both a cause and consequence of poverty

 

"Disability is both a cause and consequence of poverty. 
We're more that 2x likely to live in poverty than non-disabled people"

Disability and poverty are intrinsically linked, creating a vicious cycle that exacerbates the challenges faced by the disabled. This disparity stems from systemic barriers in education, employment, and healthcare. Disabled individuals often encounter limited job opportunities, workplace discrimination, and inadequate support services, significantly hindering their ability to secure stable and well-paying employment. According to the National Council on Disability, these employment challenges contribute heavily to the higher poverty rates among disabled individuals (National Council on Disability, 2017). The lack of accessible education further compounds this issue, as it restricts the skill development necessary for competitive employment.

Moreover, poverty can lead to or worsen disability, creating a continuous loop of disadvantage. Individuals living in poverty often have limited access to healthcare, resulting in untreated medical conditions that can lead to further disability. The financial strain associated with poverty can prevent people from obtaining necessary assistive devices or modifications, further diminishing their quality of life and ability to participate fully in society. The World Health Organization (WHO) emphasizes that this cyclical relationship underscores the need for comprehensive policies and programs that address both poverty alleviation and disability inclusion simultaneously (WHO, 2011). Breaking this cycle requires concerted efforts to create inclusive educational and employment opportunities, enhance social support systems, and ensure equitable access to healthcare and other essential services for disabled people. Investing in these areas not only improves the lives of disabled individuals but also fosters a more inclusive and equitable society, reducing overall poverty and promoting economic stability.

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A plain language version

Disability and Poverty: A Tough Cycle

Disability and poverty are closely connected. This makes life harder for disabled people. Here’s why:

  1. Education: Many disabled people don’t get a good education. This makes it hard for them to learn skills needed for good jobs.

  2. Jobs: Disabled people often face problems finding jobs. There aren’t enough job opportunities, and some employers discriminate against them. Without good jobs, it’s hard to earn enough money.

  3. Healthcare: Poor people often can’t afford good healthcare. This can lead to untreated health problems that cause or worsen disabilities.

  4. Support Services: Disabled people need special support, like assistive devices or home modifications, but these can be expensive. Without money, they can’t get the help they need.

The National Council on Disability says that these problems make more disabled people live in poverty. The World Health Organization also says that we need to solve both poverty and disability issues together.

To break this cycle, we need to:

  • Provide better education for disabled people.
  • Create more job opportunities and stop workplace discrimination.
  • Offer better social support services.
  • Make healthcare and housing affordable and accessible for everyone.

When we invest in these areas, we help disabled people live better lives. This also helps reduce poverty and builds a stronger, fairer society for everyone.

2 versions of this post

In PlainSpeak Plain Language for Lay Reader

For Scientific/Academic Audience

A kinder ABA is a therapist driving you to the point of frustration, then offering to hold your hand

https://link.springer.com/article/10.1007/s40617-023-00833-w 

Good grief is all I can say. 

Adding the prefix of "Kind" to something does not automatically make anything automatically Kinder. As is peppering a paper with the word "Kind" to sublimely influence you that it must be kind. 

And a sample size of 4 autistics in the study makes this a valid method, how?

And what did this  "kind" translate to exactly. when a therapist drives you to the point of a tantrum in the first place, then offers to hold your hand, and saying "I can see you are frustrated."

Is this a new marketing strategy by the (massive-profits with no accountability) ABA industry to make even more profits of desperate families. 

Please don't joke around with studies trying to whitewash stuff. This is not helping.  




Power dynamics of ABA

https://autisticselfadvocatesagainstaba.wordpress.com/2020/04/13/problematic-and-traumatic-why-nobody-needs-aba/?fbclid=IwAR3aeHROwIEr2uaRmsw7i1oBuOy90Cln8cMgi_nJ4bZGT87VckcUhTUoOqA

Some points that resonated in this article. 

The problem with reinforcements. 

  • "tablet time” is used as reinforcement. This is a problem because many autistics rely on their tablets for communication. Many autistics are non-speaking, and to take away their means of communication is one reason increasingly aggressive or “challenging” behaviors persist — they are not being heard or understood and the only way left to communicate their discomfort, pain, or any other needs has been taken away."
The loss of childhood.
  • "A child is typically expected to participate in 25-40 hours of ABA therapy each week; that is 5-8 hours a day of repetitive, uncomfortable, or potentially painful demands and broken down tasks, of few or no breaks, of being presumed incompetent, and of not having adequate accommodations.
  • A full-time job is expected of kids under the age of 4, and there is no strong evidence to suggest that it is effective or beneficial. Children should be allowed to have a childhood, and that is not possible when they must sit through 25-40 hours of therapy each week. This level of intervention leaves little time for rest, play, and learning outside of therapy, which can wreak havoc on a child’s mental health."
Lack of training and quality control. 
  • "Many ABA practitioners are Registered Behavior Technicians (RBT)s, which any 18-year old with a high school diploma could be by taking a 40-hour training and passing an exam."
Long term trauma and PTSD
  • "A survey of 460 autistic adults and caregivers of autistic children evidenced that 46% of those who participated in ABA therapy met the diagnostic criteria for PTSD, and 47% of those meeting this diagnostic threshold experienced severe symptoms (Kupferstein, 2018)."
Yet, still touted as the gold-standard EBT
  • "Yet ABA is still widespread throughout the United States and it is recommended under the premise of being an effective evidence-based practice. However, there is weak evidence that ABA is an effective behavioral treatment. Rated on the GRADE system the quality of evidence is low to very low (Reichow, Hume, Barton, & Boyd, 2018). In fact, “of the 58 studies done on Lovaas’ ABA therapy, only one was found to meet the U.S. Department of Education’s standards for scientific evidence."
Related Posts

An utter lack of accountability

Today there was a news article about a 7 year old autistic boy who went missing from his school during the school day. This was during a snowstorm, and he was found shivering and soaked in the middle of a busy traffic intersection by good neighborhood samaritans - and wearing just a thin t-shirt. 

The school of course insisted that the child had been missing a mere 2-3 minutes, though investigations show him having walked through a patch of woods and being outside for over 35 minutes. 

There had already been a plan in place as this autistic kid frequently eloped (a term used for kids who wander away). The police and parents were to be informed but neither happened. The good samaritans saw a kid darting about in traffic, stopped the traffic, rescued him, took him home and wrapped him in blankets. 

Unfortunately the school district missing an autistic child during the school day is more common that you would think. As is the practice of gaslighting parents on the details (fear of being sued!!). The fear of being sued apparently more critically important than any safety concerns of disabled children. 

When I was younger (~grade 3-4) I was in a classroom simply known as Room 20 in Dilworth Elementary. An autistic kid in my class did go missing for several hours. The school went into a lockdown as they searched for him. We were all asked to come indoors and stay inside. 

Later that afternoon, an old man who lived a few streets away returned the kid as he had found him wandering around. 

Of course, there was a lot of discussion in the class that day between the teacher and the classroom aides about how to downplay or not report this incident to the parents at all.  I don't know the end result of how much the parents were told,  but those overheard conversations about how to avoid revealing the truth about a missing child to its parents by educators are deeply disturbing. 

How can we autistics fully put our trust and faith in an education system if we don't believe educators (the ones supposed to nurture and help us) will only will watch their own back and not your back. 

https://www.youtube.com/watch?v=sJBoKDEUJy4

https://www.cambridgetoday.ca/local-news/autism-advocates-call-for-more-school-supports-after-7-year-old-with-autism-found-at-busy-intersection-8197389



Who has the dx, and who is the professional

This week I heard of an instance where an ABA therapist got offended at a something his autistic client did and quit over the autistic teen not following directions. 

The autistic teen had been asked to wait at a library, looks like that teen hung around for a while, and then decided to just walk back to his home alone after a while. 

I want to ask, who has the diagnosis here, who is the professional "behavior-therapist" here who is supposed to help shape behaviors instead of walking off in a huff. 

Why have the word "behavior" in applied-behavior-therapy if you don't want to even help with or deal with behavior in the first place. 

Private equity and ABA

Another example of private equity (valuation) driving ABA therapy. This does not bode well for the marginalized groups within autism and furthers the exploitative and profit hungry nature of autism therapy. 

When the focus is on $$$$, companies will turn away the "non-easy" cases (aka, autistic kids with behaviors) and take up cases they perceive are easy, so that they can show quick results to the investors. Given the heterogeneity of autism with the dx ratio now at 1:36, there are enough non-behavior kids to fill any amount of supply.   There is irony in behavior agencies turning away kids with behaviors who need help.

There is focus on valuation but not on quality control in ABA, because in autism if a kid does not improve, the fault is all on the kid, never the therapy. The one industry where there can be profits with no accountability. 


https://bhbusiness.com/2023/05/12/autism-therapy-providers-tie-upskilling-to-beating-turnover-serving-more-families/


Autism Space seen as profit making space by Private Equity

This is a continuing and troubling trend in autism. 


'...private equity investments per year tripled or quadrupled from 2018 to 2021 compared to 2015.

 ...expected investment to continue at breakneck speed

“...They needed to start showing profits and revenue that match their valuation. … So at some point, [investors] need to start seeing a return on their investment,”

 ...autism therapy space could be at the point of the investment life cycle where investors are pressuring operators to shift from scale to efficiency and profitability.

...opening clinics that reach targeted patients while being “financially healthy,” Marsh said. 

https://bhbusiness.com/2022/07/22/why-the-massive-investment-in-autism-companies-created-a-ticking-timebomb/


McGlade et al 2023: Effectiveness of Early Intervention Therapies

My take: If early childhood therapy was so "effective", then the thousands of kids who have had massive amounts of therapy all through childhood (starting with early intervention) would have "RECOVERED" may times over. Why are my challenges still significant - ie: all that therapy did not make a dent. Currently there is no such thing as gold-standard childhood therapy. Most autism therapy is hit-or-miss, at any age. Its just $$$$ spent on trial and error. Lots of careers and promotions. 

Recently there was a twitter post pointing out that since were were no readily available "statistics" (referring to it as a "cool autism fact")  showing numbers of the more significantly impacted adult autistics meant that numbers of this group must be overstated. Others in the thread  questioned if adult autistics who did not not speak, even existed, since that autistic posting had learned to speak at age 3. This an irresponsible statement and an erasure of the huge number of non-speaking or minimal verbal adults who need to be part of the autism solutions. 

Onto the paper. 

=======



Key Takeaways from paper. 
  • Limited evidence  to recommend very early interventions for infants and toddlers with autism.
    • Limited impact of early intervention for at-risk infants/toddlers (by age 3. 
    • No significant treatment effects for autism symptoms, cognitive outcomes, receptive/expressive language. Even neurocognitive outcomes (EEG and eye tracking) were inconsistent. 
  • Gold-standard early intervention is yet to be developed.  Future treatment will need to include novel and individualized intervention targets alongside the targeting of parental responsiveness.

Questions that arise. 
  • What are the implications of these findings for clinical practice and policy related to early intervention for autism?
  • What are the long-term outcomes of very early interventions for infants and toddlers with autism beyond age 3 years?
  • What are the ethical considerations related to intervening in infants and toddlers at increased likelihood of autism dx, and how can these be addressed in future research and practice?

McGlade, A., Whittingham, K., Barfoot, J., Taylor, L., & Boyd, R. N. (2023). Efficacy of very early interventions on neurodevelopmental outcomes for infants and toddlers at increased likelihood of or diagnosed with autism: A systematic review and meta-analysis. Autism Research, 16(4), 698-710. https://doi.org/10.1002/aur.2924

This is 2023. Why are shocks still part of Autistic Behavior Therapy?


This is 2023: Shocks are being used on autistics as part of ABA Therapy. The UN calls it "torture". Read this article by Eric Garcia in the Boston Globe. 


1965: The images show a Photo Essay that appeared in the 1965 issue of Life Magazine about ABA therapy being done on Autistic Kids with Dr Loovas. Shocks were used as aversives -  the floor is laced with metal strips and the autistic girl in the picture is barefooted.  



Moser, D., & Grant, A. (1965). Screams, slaps & love: A surprising, shocking treatment helps far-gone mental cripples. Life Magazine, 90-102

Vestibular, Proprioception in Autism

Lay summary:  Go to any Occupational Therapist and you are bound to hear the words vestibular and proprioception, sensory diet at least a few times.  

Why is this important: Understanding the role of sensory processing difficulties and the sensory systems involved (such as vestibular, proprioception, and somatosensory body mapping) can be helpful in developing effective interventions and support strategies for autistics.

Insights from CBT

This is not my fault

I didn't do this on purpose.

It's not fair to judge myself, because its not accurate to judge yourself. 

Remind myself, Don't judge myself for judging myself.