Catherine Maurice's Opening Remarks at Conference 2000: Science in Autism Treatment
In response to the numerous inquiries ASAT has received since Conference 2000, Science in Autism Treatment is pleased to reproduce Catherine Maurice’s opening remarks in full.
The Association for Science in Autism treatment was formed by people who shared a dream: That every family whose child received a diagnosis of autism could have access to credible information and effective treatment.
Defining that dream meant that we had to acknowledge a painful fact. Credible information and effective treatment has not been available to the vast majority of families. Instead, most of the families we knew had to wend their way through conflicting claims, internet gossip, sensational fads and strong opinions, whether grounded in facts, or not.
Treatment has for decades consisted of three major options: first we had a variety of psychoanalytic approaches, born of the assumption that autism was caused by emotional abuse, neglect, or misunderstanding of a hurting child. Under this model, a therapist tried, through play therapy or through psychoanalysis (which must have been a trick with a non-verbal child) to bond with the child, to become, in a sense, a surrogate parent. The only problem with this model, of course, is that it was based on a mistaken premise. Autism is not caused by emotional trauma or parental mishandling. The consensus, after decades of neurological research, is that it is a biological, genetic condition, that cuts across the spectrum of race, class, socioeconomic status, parenting skill or style.
Starting around the late seventies, as that type of approach began to go out of fashion (it is by no means eradicated yet), a second treatment option began to be explored. There was a rush to identify the biological cause or causes for autism, and a cure. While this is, of course, a critically important quest, it has so far resulted in a dizzying array of questionable interventions, levied on vulnerable children, sensationalized by the media, and marketed aggressively by their promoters. However, with the formation of groups such as the National Association for Autism Research, we may see one day the results of more credible research, peer-reviewed and scientifically sound. If such groups keep their standards high, and are reasonably wary of each new Lorenzo’s oil breakthrough, they may very well keep alive our hope for an effective biological treatment.
For the past few decades, a third treatment option was being refined: behavioral intervention. This approach was very pragmatic. It basically said: We don’t know what the cause is, and be may be a long way from a cure. Let’s try to teach the children whatever we can today. This approach took all tasks, from learning to get dressed to learning to talk, and broke down that task into multiple tiny steps, helping each child to master those steps at his or her own pace.
Unfortunately for all of us, behavioral intervention has been largely ignored by the psychiatric and special education establishment, who tend to dismiss it as robot training, Cruel, ineffective, etc. Now, of course, since research shows that behavioral intervention can sometimes result in normal functioning for some kids, and meaningful progress for most, some of these same folks who excoriated behavioral intervention are rushing in to claim expertise in this domain. This creates other complications: namely, the publication of books that promote a superficial understanding of behavioral science, and public confusion about what constitutes quality behavioral treatment.
But even when professionals are well-intentioned, when they wish to deliver intervention that has been researched and tested, when they are genuinely humble about what they know and don’t know, many are expressing frustration that they cannot get the training they desire, and parents are anguished when they can’t find qualified help.
How to begin to address some of these problems? Our answer was to found an organization dedicated to disseminating research-based information about treatments for autism, to support certification standards for treatment providers, and, eventually, to establish and support model training programs for therapists – in short, to do all we could to improve the standards of care for people with autism who are alive today.
Our founding members are professionals and parents. We knew that any group purporting to screen information needed professionals renowned for their high standards of scientific objectivity. We knew that any group purporting to uphold the rights of people with autism needed parents, because the principle job of all parents is to defend and protect their children. In short, we knew that parents and professionals needed each other, if we were to make a difference in the lives of people we treasure.
We are dedicated to speaking the truth about any treatment that has shown it works, or that shows true promise, according to standards of reason and science. We really do not care if that promise comes from the biological or the behavioral realm; if autism will one day be cured by eating apricot pits and chanting poems, we will embrace that treatment – if it stands up to rigorous scientific scrutiny.
And if it does not, we will not hesitate to say so. We have seen too much time, money, and life wasted on silly fads and magic bullets, in the “try anything” approach. After fifty years of this circularity of failed treatments and faulty premises about autism, it is time to move on, to create a new vision for the future, one founded on science, and inspired by trust and compassion. For after all, none of us would be involved in this arduous task if we did not believe in three fundamental principles:
- The principle of science, by which I mean that all opinions about treatment, including ours, all hypotheses and all expertise should be challenged and tested, as we seek to identify the best possible care for people with autism.
- The principle of trust, by which I mean our assumption that people with autism are capable of learning, throughout their lives, as long as we commit to teaching them well;
- The principle of compassion, by which I mean the assumption that people with autism deserve our unfailing devotion, however far they progress or not, as cherished members of our families and our communities.
One final note: in these brief remarks, I have attempted to outline our mission and our dream. But if this mission is to thrive, it must be embraced by all of us. It is our hope that by the end of this conference, you and we will become an “us” fighting together to raise the bar and improve the lot of all children and adults with autism. For it is the children, rather than any one group, any abstract concept, theory, or scientific rule, who must inspire and unite us. As the poet Stephen Spender has said:
“No cause is just unless it guards the innocent
As sacred trust; No truth but that
Which reckons this child’s tears an argument.”
This article originally appeared in an issue of “Science in Autism Treatment”, the newsletter of the Association for Science in Autism Treatment (ASAT). It may not be republished or reprinted without advance permission from ASAT. For reprint permission please contact firstname.lastname@example.org