2011-10-23

Goodbye About.com Autism by Lisa Jo Rudy

It is with sadness that I read about Lisa J. Rudy no longer writing the about.com column. It is with even more sadness that I read her final comments about ABA. In my assessment Lisa has always been objective and open minded in the best sense of open minded, meaning she seemed to take the time to read and evaluate material with an open mind, opine with respect and parsimony. The final post trashed parsimony; I think I was just, as usual, giving too much credit to well stated and respectful criticism and taking it as a chance to make things perfect. That problem is mine, perfectionism; good for my clients and the field I represent.

The final post says that she stayed away from ABA to help her son "become as fully human as [he] can be" - this is what she says should be the goal of all treatments and I will go back to this below - because of her assessment of it when done badly. And she says that it is often done badly. First I ask, how wide is her reach to enable her to make such a statement? I respect her experience and the many years she heard from others about their experiences, but there is a universe out there, states, countries. Second, isn't it the obvious thing, that any medical or educational services when done poorly, should not be chosen? Do you evaluate cardiology based on your local hospital? You should not. Third, are the other approaches she begs families will look at, always done well? What is the evidence that they can meet the humanizing goal of all therapies? The scientific evidence is not there yet and believe me, good clinicians, good behaviour analysts, are looking at the pieces that may have been missing from ALL treatments 4 decades ago and making them happen.

On the goal of all therapies being to make kids with autism become as human as they can be, as stated, this for me was a shock. Is anyone questioning the humanness of any human being? Certainly behaviour analysis is not. And saying so is defamation of a serious degree. Along the same lines, the reductionist statement about "undistinguishable" is wrong. Undistinguishable from peers is a label used to indicate the result of a group of measures used to evaluate children's abilities. These measures, of which examples are independence in daily living skills, language, intelligence, social skills, match, reading, are used to evaluate children in Western society, be the children considered typically developing or identified with any weakness in any of these and other areas. So when any field uses them to measure achievements of a treatment, it should be respected, at least as the scientifically accepted and demanded criteria. And judge individually those who make it their sole goal whilst ignoring the child's happiness and well being. Do not judge the collective based on rotten samples. Last, what is the evidence that, again collectively, behaviour analysts are not committed to "helping your child to become the person he or she truly is, and on helping your child discover his emotional self, her creative self, his personality, her passions!", and the professionals of the emerging therapies mentioned with elation, are? Do not judge the collective based on rotten samples.

The rest of the farewell post, which I had to force myself to read, is important advice and I agree that we may never find one answer to what causes autism, or ever agree on what autism is, I agree that there are horrific people engaged in targeting professionals involved in autism, I agree that life is for living so enjoy life and educate your community to allow you, I agree that that double-blind studies may tell you less than you think they will or should - I recommend looking at single-case soundly designed studies and replication as a standard - , I agree that neurodiversity is a great idea - I embrace it with love and the knowledge that behaviour analysis gave me about understanding how people become who they are.

I understand it is the writer's right to write on personal opinion. My concern is with the potential negative impact that such a short paragraph can have on families. The writer is respected and About.com is read by millions of people.