Autism Speaks Deceives Parents

As a recent post on the Left Brain/Right Brain blog pointed out, Autism Speaks engaged in a "bait and switch" when Suzanne Wright asked parents to contribute video footage of their autistic children for a new project, without disclosing any of the nasty details of what she planned to do with it. Would the contributors to the "I Am Autism" video have agreed to participate if Autism Speaks had admitted at the outset that it was planning to demonize autistic kids as embarrassing burdens who destroy their parents' marriages and dreams?

Well, at least one parent who posted a comment on the video's YouTube page, under the name BarrysDaughter, made it quite plain that she felt deceived by Autism Speaks' request for video contributions from parents. She wrote:


"I do have 2 autistic children and a husband on the spectrum. When they first suggested a video I was eager to send them one till they outlined what they wanted.

My children and husband don't want or need to be CURED what they do want is people to treat them the same as anyone else, stop the bullying and put more staff in schools to support them…"


How has Autism Speaks managed to get away with exploiting so many parents and taking their support for granted, while draining large amounts of money away from their communities and increasing the stigma and prejudice faced by their families? The answer seems to be that Autism Speaks has artfully packaged the fundraising walks as feel-good social events, thus creating pressure for people to attend because their friends are doing so, and never mentioning the fact that almost none of the money raised goes toward community services and supports. Here's a quote from a blog post written by a mother, Ange, explaining her reasons for participating in Autism Speaks walks:


"Our Autism Speaks walk is coming up soon. In the past I have had very conflicted feelings about this walk since I pretty much can't stand the organization's scare tactics. But I have walked to support my friends and their families more than anything else. I don't know if can do it anymore. I can't just write this off as fundraising anymore or ignore it while I support my friends. I can't ask friends or family to donate to an organization that makes my children look like they have some deplorable, deathly communicable disease that is spreading through the air. Nor can I in good conscience make my children participate in the walk, enforcing a message that they had no part in creating."


For Ange and other parents in her situation, I'd like to make a suggestion: It's quite possible that your friends and their families have the same concerns about Autism Speaks that you have described. Maybe, in the past, they walked to support you and their other friends more than anything else, while ignoring their qualms about the organization for the same reasons you did. It's understandable that you would worry about how your friends might respond if you said anything to them about your conflicted feelings; but you may very well discover, if you do spend a few minutes talking with them about it, that they're just as upset about Autism Speaks' scare tactics as you are.

There is power in numbers, as we know, and that power doesn't have to stay on Autism Speaks' side forever. If just a few courageous parents take the initiative to start a conversation with their friends about why fear-mongering tactics don't deserve their support, and a few of the friends do the same, and so on—then it won't take long, at all, for the voices of reason and decency to prevail.

Context and Consequences

In response to a recent guest post in the New York Times "Motherlode" blog, which used language such as "nightmare" to describe raising an autistic child, blogger Sarah of Cat in a Dog's World wrote an e-mail pointing out that such descriptions were hurtful to autistic people reading them. Her reply was published as a separate article on Motherlode and received numerous comments, some of which suggested that the mother who wrote the original guest post should not be criticized for honestly expressing her feelings and that it was natural for a parent to feel stressed by a child's disability. Sarah then wrote an entry on her blog in which she explained that she was not accusing the mother of intentionally trying to harm the child; rather, she was addressing the broader issue of the impact of such words in a culture that frequently represents the existence of autistic people as a burden and tragedy.

Looking at these posts and comments, I was reminded of a news article I read many years ago about five little Korean girls who attempted suicide because they felt unwanted after a younger brother was born into their family. The sisters overheard their father, on many occasions, talking about how glad he was to finally have a son after so many years of having had only daughters. Believing that their father did not value them as they were, the girls concluded that he would be happier if they were dead.

The reporter did not interview the father for the article, but I would guess that he did not in fact have any ill-will toward his daughters and that he was horrified by what happened. He probably never had any idea that his daughters could feel hurt by his words; after all, wasn't it entirely natural for a father to want a son?

And indeed, many parents want children who are like themselves—whether we are talking about a father who longs for a son, a ballet-loving mother who wishes her athletic daughter were more feminine, or a non-autistic parent who would prefer a highly social child. Having such expectations is not at all unusual, and parents often do find it stressful and confusing when a child turns out to be different from what they had anticipated.

In most such cases, the prevailing cultural expectation is that the parents will quickly put aside their feelings of disappointment and accept the child that they actually have. Descriptions of life with a child who differs from one's expectations as a "nightmare," or similar extreme language, would not as a general rule be considered socially acceptable and would not appear in the mainstream media unless the article had to do with learning to appreciate and value a child's differences. The potential for harm would be immediately recognized.

But as Sarah's blog entry discusses, although modern society has recognized as a general rule the importance of understanding and accommodating diversity, the autistic population often does not get the benefit of the rules that apply to everyone else. Numerous articles have described autistic people in derogatory terms that would never make it into print if applied to any other minority group. The excuse usually given for publishing such articles is that parents naturally feel that way.

It's not a very good excuse.

Dowries, Trust Funds, and Independence

I read an article by Kristina Chew yesterday discussing new legislation in West Virginia that will give tax credits to parents who contribute to trust funds for their autistic children's support as adults. Autism professional Barbara Becker-Cottrill gave an interview discussing parents' worries about what will happen to their children as adults, stating that trust funds can provide families with a sense of security.

In seeking to help families who worry about their children's future, this legislation addresses what has become a widespread concern. Because today's society is so poorly adapted to the needs of its autistic citizens, a trust fund often can be a reasonable option. I once wrote a post on this blog suggesting that parents who were spending large amounts of money in pursuit of miracle cures would be much better advised to put that money into trust funds instead.

From a broader cultural perspective, however, the idea that it could become routine to create a trust fund for the lifelong care of every autistic child leaves me feeling very uneasy. Such a system would be based on the assumption that children labeled autistic could not become self-supporting. By characterizing autism itself as the sole source of the problems encountered by autistic people in our culture, this would divert society's attention away from the many areas where it ought to be focused—miseducation, discrimination, ignorance, and lack of suitable accommodations. These are not the result of autism, but of socially constructed prejudice.

The practical effect of such a system would resemble the old custom of providing a dowry for a daughter so that she would not be left destitute if her husband died. In those days, it was taken for granted that a woman was not capable of supporting herself. Being an independent woman, to the extent that it was possible to be one, meant having inherited money from a husband or other male relative.

For many of us in the modern world, it's hard to imagine that there was once a time when a young girl, simply because of her gender, was thought to be inevitably destined to a lifetime of never being able to provide for herself. That idea seems absurdly primitive now. And yet, there are many people today who see nothing wrong with making the same assumption about a young autistic child. As we celebrate Independence Day here in the United States, I'd say that it is time to give that assumption a lot more critical scrutiny.

Michael Savage in Deep Doo-Doo

A lot of people have been wondering what the heck Michael Savage was thinking last week when he said, among other offensive remarks, that autistic children were really just brats who needed more discipline. I'm inclined to believe that the potential consequences of his rant never even crossed his mind. If he thought about it at all, he probably figured that—given the extent of the ugly, dehumanizing language so often used to describe autistic children in recent years—there would be no consequences whatsoever.

After all, "combating autism" is now an official policy of the United States government; some of our politicians and autism charities have given the impression that they're competing to see how many times in the same speech they can revile autistics as a devastating burden to society; and people calling themselves autism advocates have used language such as train wreck, tsunami, empty shell, etc., to describe autistic children for the past several years with apparent impunity. Michael Savage probably thought the language he used was comparatively mild.

But a funny thing happened on the way to the Land of Easy Laughs. Instead of shrugging off Savage's remarks as just more of the usual melodramatic language often used about autism, millions of people reacted with disgust and outrage. Disability rights groups, autistic self-advocates, and parent groups joined together to denounce Savage's bigotry and to call upon his sponsors to pull their ads from his show. Advertisers and radio stations are now abandoning his show in droves, and Savage's career is in serious jeopardy. (To put a few more nails in his coffin, visit the Autistic Self Advocacy Network for a list of advertisers to contact.)

What happened here? How did an ignorant rant about autism on a talk show that regularly features plenty of ignorant rants suddenly snowball into a career-destroying controversy? I suspect it has to do with the fact that, unlike previous insulting statements from politicians and charitable groups, Savage's rant clearly was intended as nothing but entertainment. Parents who cringed at the language used in fundraising campaigns might have been willing to ignore their qualms about it, reasoning that it was at least intended to raise money for services that their child needed. However, they were not at all willing to give a free pass to a hate-spewing shock jock.

I hope that this incident, whether or not Michael Savage ends up getting fired, will prompt more critical reflection by people who might have been inclined to overlook insulting language in the past. Politicians and fundraising campaigns do not need to demean autistic children in order to accomplish the goal of providing services. It's time for advocacy that focuses on our kids' potential contributions to society, rather than on devastation rhetoric.

That Must Be So Hard

During the Good Morning America segment on neurodiversity, Kristina Chew corrected the interviewer's suggestion that she was suffering because she is a parent of an autistic child. "I don't feel that I suffer," she replied. On Kristina's blog, a commenter named Sharon discussed how widespread this view of inevitable suffering has become, and how often she, as a parent, has to deal with this assumption that she must be suffering. Sharon wrote:


I know when I tell people that my sons have autism, the look of pity on their face and they say "That must be so hard."


Reading that comment, I was reminded of a conversation that I had almost 25 years ago with an older white woman, who was generally a nice and well-meaning person and who thought of herself as tolerant, but who—like many of her generation—had more racial preconceptions than she realized. We were talking about an African-American woman who had a light complexion, and I mentioned that her children all looked very much like her husband, whose skin was much darker.

I wasn't thinking about it in racial terms and just meant to comment on the children's close resemblance to their father; but much to my surprise, the response that I got—complete with a pitying sigh—was "That must be hard for her." Not sure what to say to that, I just stammered something to the effect that I thought she was happy to have three healthy children, no matter what color they were.

Times have changed, and it's been quite a while since I heard anyone suggest that a person of color must surely be disappointed when his or her child turns out to be darker. Most people nowadays would understand that this is a prejudiced and mistaken assumption that shows disrespect for both the parent and the child; however, it seems that very few people realize the offensiveness of making similar statements about parents of autistic children.

Granted, there are some autistic kids who did not inherit their autistic traits from a parent; but familial inheritance accounts for a significant percentage of the autistic population. (I suspect that the actual percentage is considerably higher than the genetic studies indicate, as it's likely that many multigenerational autistic families are choosing not to take part in genetic studies because of the possibility that the research could be used for eugenic purposes.)

I don't mean to suggest that pity is ever desirable, because it's not; pity always objectifies and dehumanizes those who are on the receiving end of it. Still, it strikes me as particularly obnoxious when our society is so ignorant—and so intolerant of diversity—that many parents who are autistic themselves, or close to it, are being told that their lives "must be so hard" because their children are like them.

Structural Fatigue

In response to my discussion of the recently published study of neurological conditions such as schizophrenia and depression in parents of autistic children, Joey's Mom wrote a post pointing out—quite correctly—that there are many parents of special needs children who feel exhausted and overwhelmed and who may be suffering from subclinical depression, even if they do not have a diagnosis. She wrote:


Exhaustion lurks around every corner, haunts every house, lingers in the corners and hangs in the air; exhaustion on a level I do not see in homes without special needs children, exhaustion I never see etched on the faces of mothers with no disabled children. In other homes, in other parents, there is a laugh-it-off: jokes about having drinks are lighter-hearted, comments about bad days are less edged, giggles about sleep deprivation are followed eventually by a nap or a day at the spa.

What is even more interesting is that we seem less permitted to be tired. We have to attend more meetings, talk with more teachers, run around to more therapies, and meet more needs. Many of us can't just tell the kids to go out and play while we fix dinner. Every moment is a teaching moment, every chore a lesson in life skills. Many parents doubtless think nothing of having their child dress in the morning, come down to breakfast, eat their food, put on their coat and backpack, and get on the bus. For many families I know, each step of that process must be carefully choreographed, supervised, assisted, broken into smaller steps and specifically taught.


These concerns are indeed very real for many families, and I am not trying to downplay them or to find fault with the parents' way of thinking. In my view, however, these exhausting family schedules are not an inevitable part of raising children with developmental differences. They are a consequence of the hectic pace of modern life in general, of the failure of our schools and communities to understand and accommodate our children's differences, and of rapid changes in cultural expectations. They are structural problems in our society.

A few centuries ago, a family raising a child with developmental differences would not have been struggling with any of these issues. Instead of meeting with teachers and scheduling therapy sessions, the parents would have taught the child how to do chores on the farm, just like the other children in the village. It wouldn't have mattered much if he took longer to learn, and the parents wouldn't have felt that they had to spend every moment teaching life skills. When the child played outside, he would have been under the watchful eyes of older siblings and cousins. There would have been no carefully choreographed early-morning rituals; if the child didn't dress himself properly before going out to work in the fields, a parent or sibling might perhaps have helped, but it wouldn't have been a major concern.

Of course, life was far from perfect for autistic children in those days. Many of them went through their lives illiterate and with only minimal ability to communicate. Now that our society has more understanding of developmental differences and is in the process of developing useful therapies and technologies, we have the potential to do a much better job of educating the autistic population. Still, I think we've swung too far from one extreme to the other. The villagers of the past accepted autistic children as part of the community while knowing very little about their differences and putting very little effort into educating them. Modern society has the attitude that autistic children can't be part of the community unless all of their differences are extensively catalogued and then, at great expense, thoroughly squashed. Parents are made to feel guilty about relaxing for even a moment, lest they miss some critical teaching opportunity and their child suffer a lifetime of social exclusion as a result.

We can and must find a middle ground. Autistic children, and others with developmental differences, can indeed receive many benefits from modern therapies and technologies, but the goal shouldn't be to force them to fit into a narrowly defined concept of normality; rather, our society needs to learn how to appreciate the diversity of human thought. Parents shouldn't be expected to treat every moment in their children's days as a teaching moment, frantically racing against the clock to mold their children into acceptable future job applicants in an intolerant culture where most hiring managers might as well have a large sign in their offices declaring that the abnormal need not apply.

Just think what we could accomplish if a fraction of that energy went into changing the world instead.

Researchers Discover Happy Autism Parents

Earlier this week, the mainstream media reported on a study that showed higher rates of various neurological conditions, including schizophrenia, in parents of autistic children. The study focused on families in Sweden whose children were born between 1977 and 2003, and the sample included 1,227 autistic children and 30,693 non-autistic children. (Daniels et al., "Parental Psychiatric Disorders Associated with Autism Spectrum Disorders in the Offspring," Pediatrics, May 2008.)

The popular reporting on this study gave the misleading impression that large numbers of parents of autistic children had been diagnosed with some sort of psychiatric disorder. In fact, very few of the parents had any diagnosis at all. Schizophrenia, although it had a statistically significant association, was found in only 0.6% of the mothers and 0.7% of the fathers of autistic children, as compared to 0.2% of the parents in the control group.

There's a confounding historical factor to consider here: Prior to the modern use of DSM and ICD classifications for autism spectrum conditions, many autistic children were misdiagnosed as schizophrenic. In his book Unstrange Minds, Roy Richard Grinker describes the history of autism and child psychiatry, including the confusion between autism and schizophrenia (page 105):


During the 1960s and 1970s the only mention of autism in the American Psychiatric Association guidelines was the adjective "autistic" in the criteria for "Schizophrenia, Childhood Type." In other words, if you were going to use the official categories, a diagnosis of autism was, de facto, a diagnosis of schizophrenia.


Autistic children in Europe also were frequently misdiagnosed as schizophrenic. Because many of the parents in Daniels' study were growing up during this time period, it seems quite probable that some of those who received a schizophrenia diagnosis could in fact have been autistic. In other words, the study merely confirms the obvious: if you are autistic, your children have a higher likelihood of being autistic too. No surprise there.

What may surprise some folks, however, is that the study found very little depression among parents of autistic children. No association was found between depression and being a father of an autistic child. Although mothers of autistic children were more likely to be diagnosed with depression than mothers in the control group, the percentages were still very small (1.8% mothers of autistic children; 0.8% mothers of non-autistic children).

To put it another way: Contrary to the widespread stereotype of the suicidal, emotionally devastated autism parent, these families with autistic children were enjoying their lives just like other families. The fathers were no more likely to be depressed than any other fathers, and more than 98% of the mothers did not suffer from depression. These parents weren't wishing that their child would drown or fantasizing about driving off a bridge with their child. They were going through their everyday lives just like the rest of the world.

Some mainstream publications have been presenting a more reasonable view of the lives of families with autistic children. The Autism Hub's very own Kristina Chew is featured in an article in the May 2008 issue of Working Mother, which interviews mothers of special-needs children and shows a respectful attitude toward people with developmental disabilities. The article quotes a disability consultant, who himself has cerebral palsy, on the importance of parents taking pride in their children's positive attributes and making time to enjoy their lives. Kudos to both Kristina and Working Mother; it's good to see a more realistic and accepting perspective starting to take hold in society.

Taking Care with Assumptions

In recent years, parents worldwide have been advocating for better services for their autistic children. Society has no understanding of my child's needs, they say. He will always need services as he goes through life. What will become of him after I am dead? Who will take care of him?

There's no doubt that the structure of present-day society is woefully inadequate to meet the needs of the autistic population. Still, when it's assumed that the solution consists entirely of arranging for more government-provided services to take care of autistic people, this assumption—although well intentioned—falls short of addressing the core issue. When we have a major structural problem in our society, as we do, it needs to be dealt with through radical structural change.

Parents should not have to worry about finding care for an autistic child throughout his or her lifespan. Instead, they should simply be able to take for granted—as they would with any other child—that he or she will have access to a reliable means of communication, a good education that builds on his or her strengths, equal employment opportunity in a job market that values everyone's skills, and living arrangements that are appropriate to his or her individual needs and preferences.

Having a difference or disability should not automatically equate to being a passive recipient of caretaking services forever, without any meaningful choices. Yes, autistic people need some assistance in daily life; but then, so does everyone else on the planet. We need other people's services to build and furnish and heat and power our homes, to grow and process and package our food, to weave our fabrics and sew our clothing. Nobody is truly independent. Our society takes care of all of us, in a vast multitude of ways.

If we resolved to make a collective effort to ensure that all autistics (and others with disability labels) could get a decent education and would not face discrimination in the workplace, I expect we would soon discover that most would be able to work and pay taxes and buy whatever products and services they needed. Social service agencies would then have ample funds available to help those who, for whatever reasons, could not earn sufficient wages to provide for their needs. Under this paradigm, services would be based not on diagnostic labels, but on individualized need assessments. Competence and self-determination would be assumed, rather than disorder and dependency. People would be empowered to take care of themselves.

Family History

My paternal grandfather, a native New Yorker, had some problems when he enrolled his young son in primary school in the early 1940s. Apparently, the lad wouldn't behave like the other boys or pay attention to the teacher, but spent all his time talking incessantly about his own particular interests. Send him away to military school, several people advised. That'll shape him up.

And so this skinny little boy, who wore eyeglasses and was fascinated with cameras and optical devices, was packed off on a train to a military school where he was the smallest and youngest pupil. Fresh meat, to put it bluntly. Several months later, his parents took pity on his obvious misery and brought him home; but what was to be done with him now?

Upon giving some thought to the alternatives, my grandfather decided to move to a smaller, quieter city where the school system was more welcoming. This was somewhat of a sacrifice, as he had never learned to drive and now found it necessary to hire a chauffeur, although he was not wealthy. His son thrived in the new environment, however, and went on to achieve success in his university studies as well. After graduation, his son got married and decided to become a photographer. That career choice was a disappointment, as he had planned for his son to go into the family business. Harsh words were exchanged, and neither showed much willingness to consider the other's point of view. Perhaps they were more alike than they realized.

A few years later, a granddaughter was born—an early reader who often darted away from her parents and spent much of her time pretending to be various fictional and historical characters. She was smart and full of energy, her father said; there was certainly nothing to worry about. Her mother, who felt overwhelmed at times, sought professional advice. There were mutterings about a dreaded condition called "autism." This only went to show, her father declared, that psychiatrists knew nothing whatsoever.

His darling little daughter simply needed more opportunities for enrichment, he concluded, and went on to enroll me in a well-regarded private school. My teachers were kept quite busy coaxing me down from trees on the school grounds and telling me that I had to wait until after school to be Curious George.  The principal ended up telling my parents that it would be best for all involved if they found another school for me.

A move to a small semi-rural town improved the situation considerably. The teachers were still somewhat baffled as to what to do with me, but when I got bored, they just let me sit quietly and read a book or draw pictures. There were enough trees and woods around my house so that I didn't feel the need to wander off during school hours, and the girls were friendlier and often asked me to jump rope or play four-square with them.

I grew up without ever being aware that there was anything about my development that might have been considered unusual, other than learning to read at an early age. Occasionally I heard my voice on a tape recording and thought that it sounded very different from the other people speaking, but I just figured that everyone probably thought their voice sounded weird on tape, and I didn't worry about it.

My high school and university studies went well. Although it took me a while to find a job that was suited to my skill set, I thought that was just a bit of bad luck, or possibly sex-based discrimination. It never even crossed my mind that some hiring managers might see me as abnormal. Maybe my parents should have warned me what to expect; but then, I'm not sure they fully understood it themselves.

There is now a younger generation in my extended family, which includes two autistic teenagers. Both of them are well adjusted socially and will be going away this fall to begin their university studies. They grew up attending private schools that were carefully selected to match their personality types and learning styles. They are confident of being able to succeed in their chosen careers, and I hope that they will find a job market that appreciates the vast range of human diversity.

I am cognizant of the fact that many families do not have the same opportunities for school choice, and I believe that this is a major issue that needs to be addressed through the political process. Instead of building segregated schools for autistic students, our society should be training all teachers to understand cognitive diversity; empowering parents to choose the schools that they believe are best suited to their children's needs, by way of vouchers and charter school programs; and funding these vouchers at a high enough rate to allow all teachers to be well paid, all primary classrooms staffed with aides, and all schools fully equipped with modern computers and other advanced technology.

The Foul Stench of Echthroi: Jerry Kartzinel and Jenny McCarthy

In the classic series of books by Madeleine L'Engle beginning with A Wrinkle in Time, evil is depicted as a cold, dark shadow spreading across the galaxy and destroying whatever lies in its path. The second book, A Wind in the Door, describes in more detail the evil spirits called Echthroi, who seek to extinguish all joy and life and beauty in the universe. (Anne C. at Existence is Wonderful just wrote a great tribute to L'Engle and her books; I highly recommend it.)

Although Echthroi have no physical bodies and do not speak, their presence manifests as a cold, clammy feeling in the air and a foul stench of decay. They destroy by blotting out the meaning of existence, causing a target to lose its identity and fade away and become part of the evil shadow. They cannot be fought with weapons or anger, as this only strengthens them. Rather, the way to fight back against the Echthroi is with love, by affirming the essential nature of that which they seek to destroy—by Naming all things, from the largest star to the tiniest creature. To know the names and characteristics of things, people, or animals is to make their existence more solid, more real, and more joyful.

A nasty whiff of Echthroi-stench wafted into the autism community not long ago when Jerry Kartzinel—one of the more infamous members of the Dubious Docs Formerly Known as DAN!—wrote (or perhaps quacked) in the introduction to a recently published book by Jenny McCarthy: "Autism, as I see it, steals the soul from a child; then, if allowed, relentlessly sucks life's marrow out of the family members, one by one..."

I think we all know who's sucking what in this sordid tale, and some decent folks are fighting back with the truth. Kevin Leitch has put together an excellent video response to Kartzinel and that vile, dehumanizing, exploitative statement by showing images of actual autistic children happily enjoying their lives with their loving families. Please take a look at it, if you haven't already. And if you are a parent of an autistic child, you also can take a stand against today's forces of evil by affirming your child's personhood and identity—by Naming what your child truly is:

Cherished.
Wonderful.
Human.

Poo Humor: It's the Context

Kim Stagliano, who believes that she was un-doo-ly criticized for blogging about her autistic daughters' toileting problems, has written a follow-up post in which she argues that many parents tell humorous stories about their children and that there is nothing wrong with that.

Indeed, there's a whole genre of parenting humor that consists of anecdotes about messy, inconvenient, and embarrassing incidents in daily life with the kids. And it's not unusual for such stories to involve toilets. After all, toddlers often have bathroom misadventures, and older children sometimes do. I don't object to poo humor, when it's in the general context of parenting humor.

Unfortunately, poo-smearing has become part of a very ugly stereotype that characterizes autistic people as something less than people—as pitiful, disgusting, subhuman creatures, incapable of ever holding jobs or contributing anything of value to society, not worth the expense of educating, not entitled to human rights or even life itself.

I don't mean to suggest that Kim Stagliano had anything to do with creating this stereotype; to the contrary, she has made it clear that she strongly opposes eugenics. But when dangerous ideas like that are floating around in the social ether, we need to be aware that words and humor that may appear perfectly harmless in some contexts can be seen as highly offensive in others.

Here's a brief scenario to illustrate the point: Let's suppose that a grandparent living in the Southern United States decides to have a family picnic. The grandkids stuff themselves on the food served at the picnic, which includes fried chicken and watermelon. The two youngest grandchildren are particularly messy. After the picnic is over, the grandparent writes a blog post humorously describing their eating habits, calling one of them the Fried Chicken Fiend and the other the Watermelon Queen.

Looks like just an ordinary, affectionate family story, doesn't it?

Now let's add a few more facts. The Southern grandparent is white, and the two youngest grandchildren are adopted black children. The blog entry mentions their color more than once while making those fried chicken and watermelon jokes, and the author also suggests that black skin is comparable to cancer because black skin can come in darker or lighter hues, just as cancer can be more or less severe.

Even if such a post was written with the best of intentions, and with genuine affection for the two grandchildren, it's clear that the author would soon be flamed to a crisp.

One could say that this scenario is different because autistic people are not a race. But really, it doesn't matter. Whether we look upon autistics as a race, or a tribe, or a social minority group, or a part of the disability community—stereotypes and negative analogies are just as damaging.

I'm not arguing that we all need to be poo-litically correct and avoid poo jokes toot-ally. Butt we doo need to be caca-gnizant of the social environment in which we make such jokes.

The Perils of Complaining

Many people in today's culture have become convinced that it is healthy to vent about one's problems on a regular basis. Psychological research indicates, however, that too much complaining can have the opposite effect, causing a person to become anxious and depressed about a difficult situation instead of taking constructive actions to deal with it:


A recent study found that teenage girls who vented to each other about their problems, from boy trouble to social slights, were more likely to develop depression and anxiety — and the same is likely true for adult women, says Amanda Rose, the author of the study.

"There's a definite belief in our culture that talking about our problems makes you feel better," says Rose, an associate professor of psychology at the University of Missouri, Columbia, whose research was published in the July issue of Developmental Psychology. "That's true in moderation. ... It only becomes risky when it becomes excessive."


The unfortunate consequences of too much complaining can be seen in some parents who spend large amounts of time on Internet forums and in other group settings where the members encourage one another to wallow in negativity about their autistic children. Kevin Leitch just wrote a post describing the sad state of parents who, because of their inability to accept the reality of their child's autism, spend much of their time obsessing about the magical cure at the end of the rainbow, instead of enjoying life with the child they actually have.

For those who have invested a great deal of time and mental energy in viewing their child's autism as an enemy and waging a war against their child's differences, it can indeed be difficult to consider other views and to recognize and deal with the complexity of the situation. However, those who make the effort to break out of the negative mindset are likely to find that their lives afterward are much more rewarding, as discussed by Anne C. in a comment on a post by Kristina about acceptance:


...while I’ve come across a fair number of parents who have moved from the deficit model to the complexity model of autism, I have *never* come across anyone who has gone in the opposite direction. I have never come across even one example of someone who comes to the mindset that their child can be whole, healthy, *and* autistic who has subsequently decided that they need to go back to the disease model.


That says it all.

A question for parents

When I was a small child, my father occasionally called me "George" because, like the curious monkey of the stories, if I didn't have close supervision at all times, I'd either be climbing a tree (often a very tall one) or darting away to explore something or other.

Nowadays, parents have many more options for dealing with children who have a tendency to dart off. Disabled parking tags enable parents to park near store entrances and get their children to and from the store much more quickly and easily. GPS trackers can be placed on children so that, if they get lost, it's a simple matter to find them again. Children can be dressed in T-shirts with messages like "I'm autistic, not naughty," to provide a brief explanation of difficult behavior in public places. It's only in recent years that these options have been available.

When I was growing up, it was possible to buy leashes for young children to prevent them from running off. My mother didn't want to use one, though, because she was concerned that it might damage my self-image. So she just did her best to keep a close watch on me.

I've seen a lot of discussion on parent blogs about how useful it is to have autism T-shirts, disabled parking tags, and so forth, but I haven't seen anything about how a child's self-image might be affected. So, here is my question: If you are a parent who uses (or who has used) disabled parking, GPS, autism T-shirts, or other similar means of dealing with behavioral issues in public places, how would (or did) you explain it to your child? What answer would you give if your child asked why there was a tag with a picture of a wheelchair on your car, but nobody in your family used a wheelchair? If your child were to read the message on his or her T-shirt (and even a kid who talks very little may be able to read) and wanted to know why people might not be able to tell the difference between an autistic child and a naughty child, what would you say?

This post is not intended as a criticism of parents' choices; I know it's not easy to deal with kids who dart off or who have other behavioral issues. I'm just wondering how a child's self-image may be affected by various means of managing problematical behavior and what can be done to minimize potential harm. (If any teens or young adults reading this post had firsthand experience of wearing autism T-shirts, etc., how did you feel about it?)

Chances

I got a comment from an autistic woman who is wondering if there is any way to determine the chances that she will have an autistic child, given that her fiancé also has some autistic tendencies.

As far as I know, no studies have been done that would allow such a determination to be made with any reasonable degree of certainty. (Until quite recently, most doctors and scientists did not even acknowledge the existence of autistic adults who got married and became parents.) And genetic testing, at this point in time, is very crude and inaccurate.

Of course, like most questions, this one is much more complex than its literal or surface meaning. I have to wonder: What does it say about our culture that this question is even being asked? My personal perspective on this issue comes from being part of a family where autistic traits are so common that they're seen as just part of ordinary life. In my extended family, some kids are early readers, some wander off if they're not watched closely, some enjoy sports, some are nature lovers, some arrange their toys in precise patterns and don't let anyone touch them, and so forth. We don't sort our family members into different categories based on these characteristics; it's just part of who they are.

As a result, I've never drawn the sharp distinction between autistics and non-autistics that many people do. I've known many autistic folks in real life, and to me, they just seem like ordinary human beings, not all that much different from anyone else.

To make myself clear, I'm not arguing that the autism label has no value or that it should be junked. It's useful to the extent that, in describing a general pattern of cognitive and behavioral characteristics, it enables people who have such characteristics (or whose children do) to gain access to potentially helpful information about educational methods, daily life strategies, and so forth. However, when we identify children as autistic, we should keep in mind that there is just as much natural developmental variation among autistic children as there is among any other group of human beings. They don't all have identical traits, and they don't all have identical needs. The label should be just a starting point to provide some guidance in discovering their individual strengths and weaknesses.

I'm aware that there are many people who would never consider eugenic abortion but, nevertheless, would want genetic counseling and/or prenatal testing so as to know in advance their child's chances of being autistic. That's quite understandable, given how poorly adapted our society is to the needs of the autistic minority population, and I wouldn't fault anyone for having that point of view.

Still, there are other questions that prospective parents might want to ask, such as these: What are my child's chances of being able to attend a school where he or she will be able to flourish, regardless of neurotype? What are my child's chances of being able to pursue a career that is well suited to his or her individual talents and interests, without discrimination of any kind? What are my child's chances of being able to obtain appropriate accommodations for his or her differences or disabilities, in the event that such accommodations become necessary for any reason? And what can I do, right now, to change society in such a way as to improve those chances?

Cognitive Dissonance

In response to a post about employment discrimination, James, a behavior analyst, made the following comment:


There is a sense of cognitive dissonance... If the employee was "exemplary" up to this point and all of a sudden they are deemed "unemployable," wouldn't that be illegal and unethical?


Cognitive dissonance, a concept developed by social psychologist Leon Festinger in the 1950s, refers to the mental discomfort that people experience when trying to hold two or more contradictory beliefs at the same time. They may deal with this discomfort by changing at least one of their inconsistent beliefs or by forming a new belief to explain away the contradiction.

It could be argued that prejudice is a form of cognitive dissonance because people who hold bigoted views often must deal with evidence that doesn't match those views. In the context of employment discrimination, however, I think the dynamics are somewhat different.

There are several ways in which an exemplary employee can fall victim to discrimination in the workplace without any cognitive dissonance being involved. Probably the most common way in which it happens is a change in management. The employee is hired by an unprejudiced manager and does well in that manager's department for many years. Then the employee gets a new boss who is prejudiced, doesn't know anything about the employee's past performance, and doesn't bother to look into it.

Another way in which discrimination can affect an exemplary employee is when a manager assumes, based on factors such as age or disability, that the employee's performance is likely to decline in the future. The employee's excellent record is irrelevant to this sort of prejudice because it is based on the stereotype that older and disabled employees, even if they once were good workers, are becoming less productive as time passes.

Because of the large global labor surplus, many managers also hold the view that employees are easily interchangeable. From this perspective, even if an employee has an excellent record, replacing him or her is no big deal. Companies with this sort of attitude see no downside to terminating employees who belong to an unpopular minority group, as long as the managers think they can do it without getting sued. For example, in jurisdictions where the employment discrimination laws do not cover sexual orientation, some companies have had inquisitions where they interrogated their workers en masse about their sexual preference and fired anyone who refused to answer. After all, there's always someone else in need of a job...

So I don't see much cognitive dissonance when it comes to employment discrimination. Sadly, there seems to be much more of it in parents' attitudes toward their autistic children. Like other parents, they see themselves as loving and caring people who adore their kids and want the best for their family. But at the same time, many strident voices in society are exhorting them to fear, loathe, and pity autistics. The emotional conflict in holding both of these views at once is, to use an all-too-familiar term, "devastating."

Some parents react by denying the possibility that their child could be autistic. They convince themselves that the doctors, teachers, or other professionals who recommended an evaluation had no idea what they were talking about. Any evidence to the contrary is explained away somehow, no matter how difficult it may be to rationalize.

Other parents accept the reality of their child's autism but seek to reconcile their conflicting views by insisting that it is not a permanent condition. They engage in magical thinking, such as believing that the latest fad diet or alternative treatment will make the autism disappear. Because they don't see their child as permanently autistic, they avoid having to consider the impact of their prejudices on their child.

In some tragic cases, parents who held these conflicting beliefs persuaded themselves (or were persuaded by others similarly inclined) that murdering their child was an act of love.

It doesn't have to be this way. Parents can free themselves from the cognitive dissonance trap by choosing to examine and reject society's ugly stereotypes about autistic people; but, as we know from other civil rights movements, it takes a great deal of time, effort, and mental toughness to challenge widespread prejudices.

Who Speaks for the Children?

Occasionally, parents who feel uncomfortable with autistic self-advocacy will say something like this: "Well, it's fine that all you autistic bloggers can speak for yourselves, but don't try to tell me that I can't speak for my child. You don't know my child. Unlike you, he has a lot of problems, and he'll never be able to take care of himself or do the things you do."

That's a very emotional argument, but as far as I know, there aren't any autistic bloggers claiming that parents should never speak for their children. I don't think there ever were. It's just a big old scary straw man.

Of course parents are the best advocates for their young child, autistic or otherwise. They are the most intimately familiar with the child's day-to-day experiences and needs. I'd like to see the parents in the autism community become much more willing to trust their knowledge and instincts and feel much more empowered to speak up in defense of their child's dignity and personhood, instead of being intimidated into silence by self-proclaimed experts. As most of us know, there are some seriously ignorant professionals making unfounded gloom-and-doom predictions about autistic kids. Who should be speaking for these kids? Not the prejudiced so-called experts who have no clue about autistic children's abilities and potential, and not the pity-mongering nonprofit organizations that have been using images of devastation and epidemic as a fundraising tactic—but informed, caring parents.

One of the ways that parents can become more informed is to read blogs and other websites by autistic adults. Not because we know more about a particular child than his or her parents—we don't—but because our experiences can provide more background and insight to help parents gain a broader perspective.

It's all too easy to make limiting assumptions without being aware of it. Let's imagine a society where almost all parents were firmly convinced that at least one of their children would never be able to hold a job or to live independently. Does that sound like an unlikely hypothetical future? Well, actually, it isn't. I'm describing the not-so-ancient history of almost every society on Earth. The children who were thought to be destined for a lifetime of total dependency were females.

Those who spoke out against such attitudes (feminists) were ridiculed and dismissed as mentally incapable of understanding their situation—sometimes by their own parents.

Most of the parents who held those beliefs meant well and had their daughters' best interests at heart; it just never occurred to them to question their cultural assumptions.

What Helps, What Hinders

I got an e-mail last week from a mother who complimented my blog and asked me to write an "advice for parents" post describing what helped me the most and what hindered me the most when I was a child.

First of all, I'd like to address a few general issues. There has been very little solid scientific research dealing with what kinds of educational methods, social environments, etc., are likely to result in good outcomes for autistic people. Unfortunately, that is because most researchers (and those who fund them) have assumed autism to be a disease process and consequently have focused their efforts on cure, treatment, and prevention (through eugenic abortion) of this supposed "disease."

At present, the U.S. National Institutes of Health (NIH) is accepting public comments on how autism research money should be spent. The comment period closes tomorrow (January 16), and those of us who want to see more research into what helps and what hinders the development of autistic children should take advantage of this opportunity for the general public to influence the direction of autism research (an opportunity that doesn't happen very often) by sending a comment to iacc@mail.nih.gov. The email subject heading should include "Public Comment on Draft: Evaluating Progress on the IACC Autism Research Matrix."

You can find more information and a copy of the draft report on Kathleen Seidel's blog, but even if you do not have the time to study the draft report and respond to specific points in it, a brief e-mail stating your concerns about autism research would be better than no comment at all.

A petition will be sent to the NIH tomorrow, asking the NIH to approach autism research with respect for human diversity and to direct more funding to the study of autistic abilities and positive outcomes. Please read the petition and sign it if you agree with it.

I would also like to caution parents that any information or advice from me (or any other individual) should not be taken as representing the experiences of autistics in general. Some researchers have estimated the prevalence of autism spectrum conditions as 1 in 86; if this is accurate on a global scale, it would mean that there are about 70 million autistic people in the world. Conclusions about such a large population should not be drawn from a small sample of individuals. I encourage parents and others who want to learn more about autism to read a wide variety of blogs and websites by autistic writers (the Autism Hub is a good place to start) and to talk with autistic adults in real life, if possible.

Another related caveat: All of us, whether autistic or not, are products of our social environment to a large extent. Because I grew up in an environment where I was treated as a person like everyone else, I look upon my experiences as human experiences, rather than specifically autistic experiences. By contrast, those who often heard their behavioral traits described in medical or psychological terms during their childhood (as autistic "symptoms" or something similar) are likely to characterize their experiences as unique to autistics. Neither of these perspectives should be assumed to represent the full scope of autistic experience.

Now, on to things that helped and hindered me specifically: Books were very helpful for broadening my world as a young child. I learned much more effectively by reading than by listening to spoken conversations. Not all autistic children are visual spatial learners, but I believe that having plenty of books in the house during a child's early years (and reading to the child regularly) is beneficial no matter what the child's learning style may be.

Being able to play outside regularly and to go on long walks exploring my surroundings was also helpful. That gave me a better understanding of the natural world and a feeling that I was part of it. Many children nowadays (both autistic and non-autistic) are kept indoors most of the time because their parents worry that they will not be safe outside, and I think that's very sad. Children need time to chase butterflies, look for the end of the rainbow, and investigate wildflowers and shiny pebbles. Television and video games, no matter how good the picture quality may be, aren't a substitute for actual hands-on exploration of the real world.

What helped me the most? My parents had an easygoing and accepting attitude toward my development, however different it might have been from that of other children. They never made me feel that there was anything wrong or unhealthy about me. I grew up assuming that everyone was different in one way or another and that this was OK. Although my parents probably had some worries from time to time, they never discussed their worries in front of me. I was encouraged to follow my interests and was told that I could grow up to do whatever I wanted to do.

What hindered me the most? Well, the usual stuff that stresses out children in general... my parents getting divorced, having to move because of that, and the related disruptions. To some extent, however, there were positive effects (in a "what doesn't kill me makes me stronger" kind of way). Although I went through a few years of acting up at school and other places, my ability to deal with change improved significantly. Years later, when I looked back on my childhood, I saw myself as a capable, healthy person who had some school problems because of stress, rather than as a disordered or abnormal person. But that wasn't entirely for the best, either; I had no idea how the rest of the world saw me, and I wasn't at all prepared to deal with discrimination after I left college and went out into the business world (it took me quite some time to understand what was going on).

So there's a trade-off that parents need to consider: Too much information about a hostile world and its prejudices can cause a child to despair, but too little can leave the child unprepared for real life. Parents need to be very careful in deciding what to say to (and in front of) their child about the child's differences. This is, of course, an issue for all minority families, not just for families with autistic children. I hope that as our society becomes more accepting of human diversity, tomorrow's families will not have to face such choices.

The Freedom to Make Mistakes

Some parents now are being advised, by professionals and Internet support groups, that the best course of action with an autistic teenager is to apply for guardianship while he or she is still a minor because the court will grant it routinely. Even if the teenager in question is responsible, well-behaved, and doing fine in school, the parents are told that a continuing guardianship is necessary because autistics are just too naïve socially to protect themselves from being cheated in the big, bad, evil world out there.

Here's a reality check: Millions of young adults rent overpriced apartments, run up credit card debt buying products they don't need, respond to slick advertisements as predictably as Pavlov's dogs, get cheated buying used cars, and make other unwise decisions. Most of them are not autistic.

Not all that long ago, parents simply took it for granted that if a teenager was naïve, he or she was going to end up learning a few useful lessons in the School of Hard Knocks. Making mistakes and learning from them was considered to be a natural part of the process of gaining life experience and wisdom, not a horrible calamity to be avoided at all costs.

Before the autism diagnosis came into common use (again, not all that long ago), parents often encouraged their socially inexperienced teens to get more involved in the world and to make more decisions, so that they would learn how to go about it. Now, however, expectations have shifted radically for those with the diagnosis. They are being redefined as perpetual children who cannot choose to work, marry, rent an apartment, or make any other adult decisions.

This is how human rights disappear.

Let's go a little farther back in history, to the days when married women could not own property or enter into contracts. These laws were based on the cultural assumption that women were naïve, childlike, and in need of protection. Similar attitudes were found among the supporters of slavery and segregation, who often argued that blacks did not need equal rights because they were not capable of making intelligent choices.

Given the fact that women and blacks were systematically excluded from almost all aspects of the business world in those days, it's likely that many of them actually were much more naïve and easily cheated than white men. But the remedy for that (as society discovered in modern times) was to provide better education and equal opportunity, not a permanent and total deprivation of civil rights.

The same holds true for autistic teenagers. There are financial education classes that teach young people how to create and live within a budget, how to handle credit prudently, how to rent an apartment, and other useful information on how to manage money. Parents can, and should, talk with their teenagers about sensible rules for making financial decisions—such as not making a major decision without taking time to research and reflect on it, not buying a used car without having a mechanic check it over first, and so forth. Achieving a basic level of financial literacy is just as important as learning the subjects taught in school.

Yes, they'll make some mistakes (just as most non-autistic teenagers will) but the consequences usually won't be serious, and they will learn from their experiences, as they do in other areas of life.

One of the freedoms most vital to our civil rights is the freedom to make mistakes.

The Cost of Cure

You'll find heaps of statistics (many of which contradict each other) floating around the Web about the cost of raising an autistic child. Some families spend $50,000 per year (or more) for an ABA program. Others go into debt to buy large quantities of therapeutic toys, or to fill their medicine cabinets with assorted biomed products, or to fly their kid to a tropical resort to swim with the dolphins. One thing is for sure, if a parent of an autistic child has money in the bank, there's always somebody around to make a sales pitch.

The essay I Can't Ever Die, on the Autism for Parents website, explains why so many parents are willing to spend these large sums. When they find that their child is autistic, parents often worry about what will happen if the child needs lifelong care. Who will provide for him when they are gone? How can they be sure that he won't end up helpless and destitute in an institution somewhere? This overwhelming fear and anxiety drives many parents to seek cure at all cost, believing that any expense and risk must be justified to save their child from such peril.

Anxiety about the future of one's child seems to be a common experience of parents generally, whether or not the child is autistic. This research study found that parents have significantly higher levels of depression than non-parents and that their depression levels increase as their children get older. The increase was attributed to anxiety about how well the children will be able to take care of themselves.

No doubt these strong emotions had a lot of evolutionary value to our cave-dwelling ancestors by motivating them to ensure that their offspring would be able to survive in society, but in the modern world, such fears often turn out to be both illusory and counterproductive. Let's take a look at what would happen if these parents, instead of spending large sums in a desperate quest to cure their autistic child, chose to put the same amount of money into a trust fund.

I'll assume, for the sake of discussion, that our hypothetical parents are 30 years old when they learn that their 3-year-old son is autistic. They begin contributing $50,000 per year to a trust fund for the child and continue to do so for the next 15 years. Let's suppose it earns an effective interest rate of about 5 percent, after taxes and trust administration fees.

By the time their son is 18 years old, there will be about $1,200,000 in the trust fund. At this point, the parents stop making contributions (they're 45 now, and they need to set aside money for their retirement). Perhaps their son is still living with them, or in a house or apartment nearby, and needs help with some of his daily activities. The money in the trust fund continues to earn interest.

Assuming conservatively that the parents die at age 75 and that they do not leave their son any inheritance by will, other than the family home, he's going to be in good shape financially at age 48, with more than $5,000,000 in the trust fund. Granted, that won't make him wealthy because of inflation, but it will be more than sufficient for a comfortable upper-middle-class lifestyle and whatever household help he may need. His future will be secure, even if he never works.

Now let's suppose that, after a happy and stress-free childhood, he naturally develops the skills needed to live on his own (as many autistics do) and to pursue a career. In that case, his parents will have an ample fund for his college education and for helping him to get off to a great start in his adult life.

And the value of being raised in an understanding and accepting family? Priceless.

First, Do No Harm

In recent posts, Not Mercury and Kevin Leitch observed that it's hard to say much about causes and cures when we don't even have a clear definition of what we are talking about. And they're right. The autism debate often reminds me of the fable about the blind men and the elephant; they all touched different parts of the animal and then argued about whose description was more accurate.

The science simply hasn't progressed to the point where we can make definitive statements about the causes of autism (and we may be talking about many similar conditions with separate and distinct causes, given the breadth of the diagnostic criteria). In the absence of clear definitions and solid peer-reviewed research studies, we end up arguing from our personal experiences. Somebody will declare, "I have five autistic family members, so it can't be anything but genetic." Someone else will argue just as vehemently, "There's no history of autism in my family, and my child never had any autistic behaviors until he got a certain vaccine, so that must be the cause." And all around the mulberry bush we go.

What can be done when science gives us so little guidance? It's instructive to look at the teachings of an ancient Greek physician, Hippocrates, best known as the author of the Hippocratic Oath. He founded a medical school where he stressed the importance of thorough clinical inspection and observation. The Hippocratic Oath, still used in various modified forms today, requires physicians to seek only the good of the patient, to maintain confidentiality, to avoid conflicts of interest, to refrain from performing dangerous procedures as to which they lack professional expertise, and to "first, do no harm."

Hippocrates was a wise fellow. He understood that there are limits to medical knowledge and that we must proceed very cautiously when we go beyond those limits. Although modern medical science has advanced far beyond the simple herbal potions and crude surgeries of Hippocrates' day, a great deal of uncharted territory remains, and we still need to be careful.

Because so little is known about autism (and not all modern medical practitioners are as careful and ethical as Hippocrates), parents of autistic children should thoroughly research any drug, dietary supplement, conventional or alternative medical treatment, behavioral therapy, etc., that they are considering. Drug reactions and medical errors are a leading cause of death in industrialized countries. Although some "natural" diets and supplements may be safer than pharmaceutical drugs, no alternative treatment should ever be assumed to be risk-free.

The emotional effects of any treatment on a particular child, as well as the physical effects, should be considered. If a child repeatedly resists taking a particular drug or undergoing a particular treatment, it probably is not right for that child, even if it does not appear to be causing physical harm. In many cases, an autistic child who is experiencing pain or physical discomfort will not be able to communicate this fact effectively. Moreover, prolonged emotional stress can lead to painful physical conditions such as gut problems, as well as behavioral issues. Long-term emotional damage can result. To put it more simply, a child shouldn't have to grow up having medication forced down his or her throat every day. (I know a woman with asthma whose stepfather forced her to take her medication by standing over her brandishing a switch every day while she lay sobbing on the floor, which surely made her asthma much worse, in addition to the emotional trauma.)

The language used to describe treatments and therapies, as well as to describe autism in general, is another area where parents need to be careful. A child who is often described as sick, damaged, defective, and so forth, will come to internalize these views and to feel that he is good for nothing. If, on the other hand, the parents talk about the treatments and therapies as an ordinary part of life and avoid using disease terminology, the child is likely to have a much better self-image. Even when the child is not around, parents should be careful about the language they use to describe autism because it affects how society will treat their child. For example, Internet forums and other websites that dwell on the negative characteristics of autism are not just harmless venting like real-life conversations with friends; because they are read worldwide, they greatly amplify society's prejudices against the autistic population.

Parents also should consider carefully whether treatments or therapies are in fact necessary for the child's well-being. To the extent that natural behavioral differences are not detrimental, they should be accepted. Where behavioral problems need to be remedied, parents should consider whether the desired results can be accomplished by changing the child's environment, rather than changing the child to fit into a particular environment. Every child should be able to grow up believing that he or she is a worthwhile human being, not a problem to be solved.

First, do no harm.