One of the hottest issues on the burner in regards to autism is health insurance reform. The heavily capitalized organization Autism Speaks has been in the forefront in this venture. Regular readers of gadfly have seen my previous post regarding health insurance reform in which claims were made that this would help autistic become "functioning adults" and the citing of the nearly 50% recovery rate reported in Lovaas(1987). This is in spite of the fact that Lovaas and company have been paid handsomely by their ability to use NIMH funding as a proverbial ATM machine and get funding to publish the adult outcomes of their subjects in a peer review journal and the fact that they have failed to do so. We also have the phony/baloney cost-benefit analysis presented by Jacobson et. al. claiming that the potential earnings of autistic kids and their ability to be kept off the dole will far exceed the costs of ABA. The informal presentations of the adult outcomes at a conference were presented as evidence. No matter they either did not pass peer review or the outcomes were actually less than stellar so they were not published. No matter the absurdity of Jacobson and company assuming that interest rates will remain constant for decades and an inflation rate of zero for decades in their extremely sophomoric analysis. Not to mention the fact this assumes the 40 hour a week regimen with aversives that have been outlawed in many jurisdictions, along with clinic based ABA, as opposed to the workshop based ABA that is often used involving less hours, and lesser trained personnel that are paid for at taxpayer expense under IDEA. Lovaas(1987) used the clinic based ABA with highly trained personnel and the 40 hour a week setup for the experimental treatment group.
I realize I am rehasing some old issues I have written about before but it relates to the latest abominable campaign by the petty propagandists who run the show at Autism Speaks. I have already written about the despicable dog and pony show put on by autism speaks in terms of trying to encourage employers to hire autistics, yet not employing a single person with autism in their organization not even as a minimum wage file clerk with a job coach.
Sigmund Freud said to love and to work are the cornerstones of our humanity. So, it should certainly not be surprising that autism speaks has filled in the second half of the equation trivializing the horror of this terrible disability that presents autistics from having not only being deprived of their humanity by often not being able to work, given the high unemployment rates for autistics and others who are disabled, but also claiming that their insurance reform crusade is some sort of easy quick fix to ensure that autistics will have friends if the treatments of choice are paid for with health insurance. The following video has recently been produced by autism speaks:
In this brief clip, we see a boy with autism who apparently received treatments that were covered by insurance being invited to play a game of soccer by a neurotypical child and being accepted. We see a second boy with autism, who did not have the insurance coverage enabling him to get help, being rejected by peers.
My question to Autism speaks is Where's the beef? I have ofcited the problems with Lovaas(1987) and the groundless claims that have been made for it. But Lovaas (1987) only deals with IQ score tests and the ability to complete a normal first grade and subjective impressions by school teachers as the dependent variables being studied. There is no empirical evidence that this treatment enabled autistic children to better able to make friends or acquire a boyfriend or girlfriend. How can speech therapy enable a person to acquire friends. I am a formally nonverbal autistic who recovered his speech, yet the recovery of my speech has not enabled me to have successful relationships with people. I remain largely friendless and celibate. I also underwent perceptual motor training in the 1960s which might be comparable to some of the occupational therapy that these insurance reform crusades are trying to get the insurance companies to cough up the payment for. Not only were these worthless in helping my handwriting, fine motor and perceptual motor impairments, they did nothing to help me in my social life either.
So, really, how can any of these therapies help a child make friends and be accepted by peers. My inability to love and work due to my autism has stripped me of my humanity that Freud wrote about over a hundred years ago. Autism speaks in their zeal to provide a quick fix has trivialized my lack of humanity as well with this demagogic campaign and video. The capital behind this organization and others, and the other lobbies are so powerful, they will likely get the insurance reform they want. Not only in the legislatures of all 50 states but with the federal government as well, closing any loopholes. The results will wreak financial havoc on Blue Cross, Kaiser and other hapless health care providers when the plethora of families affected by autism are fueled with the false hope that this video gives, not to mention the lower quality of health care we will receive because these insurers have to pay for autism therapies. The cost of health care insurance in the U.S.A., which unlike other countries has no national health coverage ,will undoubtedly skyrocket even more, considering how much it is increased, considering as many as 1/150 children may be receiving these treatments once they are mandated.
I think of not only all the women that have rejected me and how unfriendly they were to me, I also think how hard it was for me as a child, constantly getting into conflicts with other kids my age, being teased and picked on, being rebuffed and being kicked out of their homes because they found my behavior and autism so offensive and they were so prejudiced against me. So, according to autism speaks' latest propaganda campaign, had these "evidenced based" therapies been available in my childhood, had I done these interventions instead of undergoing psychoanalysis, and my parents' medical insurance had paid for them, I would not have been rejected. I would have just been fine. Instead of the arguments and other kids kicking me out of their houses, I would have been invited on playdates. I would not have been rejected and rebuffed by peers. How comforting it must be for parents and their children to know, these "evidenced based" therapies will ensure that they will not only have to worry about unemployment, but will have a ton of friends and girlfriends to take to their regular high school prom. They can make their six figure income, marry their high school sweetheart they took to the prom and live happily ever after. Perhaps I sound bitter in this post because I am.
Well maybe after all these insurance bills are passed and the millions upon millions of dollars of reimbursement that will be coughed up for all of these "evidence based" treatments are paid for, maybe we will see some studies or peer reviewed evidence actually showing that at least some of these autistic children were able to lead a normal social lives. If not, perhaps autism speaks will have even more reduced credibility. No one will probably even noticed that they gave Laurent Mottron, a medical doctor who states that autism is not harmful and is no dysfunction and is only a difference and posthumously diagnosed one historical figure he could not have possibly met since he was born after this person's death half a million bucks to do research showing how well high functioning autistics can do on various tests and tasks. But if these insurance paid treatments don't work, perhaps some people will take notice. Perhaps, there will be more internal strife in this organization than we are now witnessing with the resignations of Allison Tepper Singer and Eric London. Perhaps AS will end up losing their donations. They might have to sell their Lear jet, cut Mark Rothmeier's (sp???) salary by a few hundred thousand dollars and perhaps cut out some other frills.
Of course, I might be wrong, we might be seeing some autistic kids getting married young, winning popularity contests and being elected presidents of their student body.
Let the chips fall where they may.