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‏إظهار الرسائل ذات التسميات adult autism care. إظهار كافة الرسائل
‏إظهار الرسائل ذات التسميات adult autism care. إظهار كافة الرسائل

Report: Families Face Staggering Autism Care Costs


The image above is the cover page for the report of the University of Calgary School of Public Policy: The Value of Caregiver Time: Costs of Support and Care for Individuals Living with Autism Spectrum Disorder.  The report deals with the harsh realities that many involved with government, the media and many autism groups do not wish to address. In itself that is highly unusual.  Here in New Brunswick we have had some initial successes in developing evidence based early autism intervention and school services.  We have had almost no responses in addressing adult care for autism.  Recently our government did conduct a pilot project in training support staff at a group home and that is about it after a dozen years of advocacy.   The costs of avoiding the issues have fallen largely on families with some ad hoc solutions, often costly ad hoc solutions, implemented by government.  Hopefully this report from the University of Calgary School of Public Policy will be taken seriously by our NB provincial government (as well as other provincial, territorial governments and our federal government).  The official news release of the School of Public Policy follows:
CALGARYJan. 15, 2014 /CNW/ - A report published today by The School of Public Policy identifies staggering costs associated with autism and advocates increased support for families dealing with this challenge.
"An autism diagnosis of a high-needs child at age two represents the equivalent of telling the family that they must make an immediate lump-sum investment on that day of $1.6 million, invested at a five-per-cent return, to pay for the lifetime costs of care and support their loved one will require," write Herb Emery and Carolyn Dudley, the report's authors.
These numbers form only a part of the authors' analysis, which charts lifetime support-care needs and costs for three hypothetical individuals living with varying degrees of autism spectrum disorder (ASD). The annual value of caregiver time for a "high-needs" case is $158,359. For a moderate-needs case it is $82,769 per year and for a lower-needs case it is $30,711 per year.
The authors argue that regardless of the case, costs are often underestimated by society and government, and families are left shouldering most of the burden.
"A scan of provincial programs finds a patchwork of unequal and incomplete supports for individuals living with autism spectrum disorders. Gaps are particularly evident once individuals leave the public school system, where they are at least provided with some form of day support. Sufficient adult day supports, evening and night supports, quality group homes, the availability of properly trained caregivers and respite services, recreational activities, post-secondary opportunities and employment supports all suffer varying levels of inadequacy across the country," the authors write.
Emery and Dudley identify several approaches to relieve pressure on families. Increasing the current annual caregiver tax credit of $300 is one option. Government can also show its support by providing funding to help boost the supply of caregivers and care centres. Introducing autonomy insurance, which has already been proposed in Quebec, is another government initiative that could assist adults with disabilities.
Removing the IQ screen for eligibility of services at age 18, which exists in some provinces, is another measure endorsed by the authors. This would help individuals living with ASD who have higher IQ but lack functional skills of independence. Offering these individuals support could assist them in gaining employment, which would eat into the overall costs associated with their disorder.
SOURCE The School of Public Policy - University of Calgary
Video with caption: "Video: Carolyn Dudley details the staggering costs faced by families with children with autism and what policy measures would help alleviate this financial burden.". Video available at
 For further information:
Media Contact:
Morten Paulsen
Phone: 403.399.3377
Email: morten@paulsengroup.ca

Adult Autism Care in New Brunswick: An Open Letter to Premier David Alward

 



May 6, 2013

Honourable Premier David Alward
Respected Cabinet Ministers and Party Leaders

Dear Premier Alward

I am the Acting President of the Autism Society New Brunswick  and a parent that was involved, with many  other parents, in the advocacy that led to the establishment of the UNB-CEL autism intervention training program, the provision of early autism intervention to children aged 2-5, UNB-CEL  autism specific training of Education Aides and Resource Teachers and the reversal of the decision to close the Stan Cassidy Center tertiary care autism team. We also argued with some modest success for an evidence based, student centered, definition of inclusive education. We have been less successful in advocating for  a continuum of placement options to accommodate the varied, complex needs of autistic students although individualized instruction does continue in some schools. 
 
Autism successes in New Brunswick have resulted from many factors including access to sound, knowledgeable, professional advice that oriented us toward evidence based, scientific goals to assist our children's very challenging needs and responsive  leadership in the Lord and Graham governments.  Despite these gains, which are in need of further refinement and advancement,  we must, with sorrow, shame, and fear, acknowledge that  we have to date failed to see any substantial improvements in services  for New Brunswick adults with autism disorders. That failure, like the aforementioned successes, must be shared by parent advocates and government decision makers.
 
Several news agencies have highlighted events in Ontario where parents left their 19 year old severely autistic son with a government office because they were unable to continue providing him with the necessary level of care.  Many New Brunswick parents including me, and my wife, have also long feared that day. That fear grows stronger with each year of non action, each year of failure to address seriously the needs of autistic adults across the autism spectrum. 
 
Many parents in New Brunswick seek meaningful assistance to help care for their adult autistic children in their homes.  Obviously at some point parents grow too old or exhausted and ultimately become enfeebled and pass on. We do so  with the knowledge that no credible, comprehensive autism care system is in place to care for our adult autistic children who require assistance when we can no longer help them.  Moderately to severely autistic and intellectually challenged autistic adult children will face serious difficulty living in group homes with untrained staff and non existent educational and social options.  Our most severely affected autistic adults will live in the Restigouche Regional Hospital psychiatric unit or in facilities out of  province like the Spurwink facility in Maine. 
 
Money is always an issue in government decision making and that is understood by all.  However, the failed group home system that exists in NB   also carries costs such as placements in Spurwink Maine at several hundred thousand dollars a year per individual.  Money is part of the problem but so too is the overwhelming dominance of the "community"philosophy in the mindsets of NB's public decision makers.  There is no question that those who have promoted the community/inclusion model in NB have made very substantial contributions to the lives of most persons with disabilities in our province but  the dominance of their beliefs, and the rigidity with which they are maintained, precludes the development of evidence based alternatives and prohibits the development of a facility that can provide permanent residential care and treatment for those with severe autism and co-morbid disorder challenges.  
 
Autistic residents of group homes have been charged with assault when in conflict with untrained staff.  An autistic youth was housed temporarily on the grounds of the Miramichi correctional facility and at least two New Brunswick residents with autism have been sent to Spurwink in neighboring Maine.  We do not have a modern, professional,  permanent residential care and treatment facility for adult New Brunswickers with severe autism in large part because of the rigid adherence to a decades old philosophy that simply ignores contrary evidence including those persons who are sent to psychiatric and general hospital wards, out of province facilities and correctional facilities to spend their lives.  Public events to discuss disability policies and service requirements are typically organized in pre-arranged "table discussion" formats that prevent serious open discussion of contentious issues.
 
Over the last decade the Autism Society New Brunswick advocated for a continuum of residential care and treatment options to provide for our autistic adult children.  Three years ago, during the 2010 provincial election,  UNB Professor Emeritus (Psychology) and practicing clinical psychologist Paul McDonnell articulated in a CBC interview the concept of a continuum or network of residential care and treatment center.  Professor McDonnell spoke of the need for a modern adult autism residential care and treatment system in New Brunswick with a center that would provide residential care and treatment for those severely affected by autism, a center that could also assist in the training and service provision in group homes and facilities in communities around the province.  The center would be a modern facility that could provide educational and social elements in the lives of severely autistic adults. No progress has been made in moving towards such a home grown solution notwithstanding the international recognition that NB received for its successful UNB-CEL early intervention autism training program.
 
On behalf of the Autism Society New Brunswick, and parents of autistic children and adults, I ask you Mr. Premier to commit to the modern, professional system of adult autism residential care  articulated by Professor McDonnell.  An adult autism residential care and treatment facility based in Fredericton, with professional administration, trained staff, evidence based treatment,  education and social programs for the residents is needed.  An autism center would  provide desperately needed  permanent residency for the most severely affected by autism disorders, training and advice for staff in community based group homes, and assistance for parents whose adult children are still living with them.  The Fredericton location would be centrally located and in close proximity to other New Brunswick autism successes and expertise at UNB and the Stan Cassidy Center.  
 
Much time has passed with no serious response to our calls to address the needs of autistic adults. There has been no progress to date. Hopefully that will now change and work can begin as soon as possible on the development of an autism residential care and treatment facility.
  

Respectfully,

Harold L Doherty
Fredericton

cc. ASNB
      media

Conor's Autism Diagnosis 15 Years Ago Today




Conor, 2nd Birthday, the day before he is diagnosed with 
PDD-NOS (subsequently changed to Autistic Disorder)

Yesterday was Conor's 17th birthday.  Today is exactly 15 years since he was diagnosed with an autism disorder, PDD-NOS, the day after his second birthday shown in the pictures above.  Shortly afterward he was re-diagnosed with Autistic Disorder, and he was also subsequently assessed with profound developmental delays.  I can't say that I am overly impressed with the research into autism causes, treatments or even our understanding of what constitutes autism that has taken place in the last 15 years.   15 years ago intensive early behavioral intervention was the only seriously evidence based intervention for autism as it remains today. 15 years  after Conor's initial diagnosis there are no substantial breakthroughs in understanding the biological basis of autism as the goal posts keep getting moved to allow the dominance of genetic autism research to continue and to continue with the lion's share of research dollars. Today, like 15 years ago, possible environmental contributors to autism are largely ignored and receive only a small fraction of the autism research dollars available. 

Even our understanding of autism diagnostic criteria are about to change again and for what reason?  The DSM5 does not hold out any serious hope of increasing our understanding of autism disorders, symptoms, causes or possible treatments.  The DSM5 will undoubtedly muddy the waters of autism research even further. Debates still rage over whether the astonishing increases in autism diagnoses of the last 15 years are real or whether they are caused by increased social awareness and ... the diagnostic definition changes of the 1994 DSM-IV.  NOW in Conor's 15th year post autism diagnosis yet another definition will be forced upon North Americans?  How can this possibly help autism research?  

Services have been obtained for autistic children in various parts of North America in the 15 Conor autism years.  Here in New Brunswick I joined with other parents fighting for early intervention, school and services for autistic adults.  We made significant gains in early intervention service delivery as recognized by Dr. David Celiberti of the Association for Science in Autism Treatment and in our schools.  In adult care nothing has changed as yet,  nothing at all. Here in New Brunswick, Canada, we still dump our severely autistic adults in hospitals, jails, hotels and foreign facilities rather than develop our own enhanced adult autism network.  Many others live in group homes with untrained staff. The gains we made in early ntervention and schools are being eroded and adult care has not been addressed at all.

If I sound gloomy I don't intend to be.  I will advocate for Conor as long as I am alive and I can only do so by  being honest.  His autism challenges are real and I will not betray him by pretending that his autism is a joy.  Conor himself is a tremendous joy and the proof is in the pictures you can find on this blog site and on my Facebook page which is open to public view.  See for yourself.  Conor's autism is no joy but he sure is. 

Autism Society New Brunswick Invitation to Premier Alward, Ministers, Opposition Leaders to Attend ASNB AGM


February 7, 2013


Dear Honourable Premier Alward, 
Honourable Ministers, 
Respected Leaders of the Liberal, NDP and Green Parties of New Brunswick

You are all respectfully invited to attend the 2013 annual meeting of the Autism Society New Brunswick scheduled for March 23, 2012 commencing at 12:30 at MacLaggan Hall, UNB Fredericton.  The meeting will be open to anyone in New Brunswick affected by or with an interest in autism spectrum disorders.

The Centers for Disease Control (CDC) in the United States currently estimates that 1 in 88 persons will be diagnosed with an autism spectrum disorder (ASD).  The primary diagnostic features of autism as set out in the DSM and ICD diagnostic manuals indicate three primary concerns of deficits in  social, communication and restricted, repetitive and stereotyped patterns of behavior, interests and activities. Serious features often found in conjunction with autism include intellectual disabilities, epilepsy and seizure activities, sensory issues and self injurious behaviours.

In our province the Autism Society New Brunswick and our parent members have been instrumental in advocating successfully for evidence based early intervention for children with autism disorders. We were actively involved in assisting in the creation of  the internationally recognized UNB-CEL Autism Intervention Treatment program.  Our advocacy prompted the UNB-CEL autism training of approximately 500 education aides and resource teachers. 

It was also the ASNB representation during the inclusive education reviews  of the Lord and Graham administrations (MacKay,Ministerial Committee) that helped ensure the emphasis in the PNB definition of inclusive education on a student focused, individualized,  evidence based approach to inclusive education.  We have further advocated for the maintenance of a range or continuum of learning and placement alternatives in providing inclusive education; consistent with principles enunciated in Canadian case law such as the recent Moore decision of the Supreme Court of Canada and by credible autism authorities such as the TEACCH Autism Program at the University of North Carolina. 

ASNB and our representatives have also advocated persistently, albeit with very limited results, for systemic improvements in adult services.  One key area that has repeatedly been brought to the attention of government, and for the most part ignored,  is the need for an enhanced network of residential care and treatment  for New Brunswick adults with autism as described by respected New Brunswick autism expert Paul McDonnell.  

The adult care issues are of grave concern and have not been seriously addressed in NB at all.  There are also serious concerns among parents about a perceived regression in provision of early autism intervention with valuable early intervention time being lost needlessly by bureaucratic and service provider procedures. In our schools the quality and integrity of the UNB-CEL autism training has been replaced by an in house autism training model which the ASNB objected to strenuously over many years.  Pressures are continually being exerted to place all students with autism disorders in regular classroom settings contrary to the legal and professional requirements noted above for a continuum or range of education settings and service delivery based on the needs of the individual students.

The issues articulated are  provided in an attempt at candid, courteous discussion of issues that are of fundamental importance to our ASNB members and persons affected by autism. They are provided to avoid surprise and to allow any respected invitees who choose to attend to come prepared for discussion without fear of being "bushwacked".   This invitation will itself be placed in regular and social media consistent with ASNB practice of transparent, arm lengths and public approach to autism advocacy that has worked so well in dealing with previous administrations. 

if you choose to attend you will be welcomed on behalf of the  1 in 88 persons in New Brunswick and their families. Kindly reply as soon as possible  to this email if you wish to attend so that preparations can be made to accommodate any needs, requirements or concerns you might have in attending. 

Respectfully,
  
Harold L Doherty
Acting President (ASNB, 2012 AGM)
Autism Society New Brunswick

cc.  ASNB, media  

Ontario and New Brunswick Need Adult Severe Autism Care Facilities


Ontario and New Brunswick Both Need Adult Severe Autism Care Facilities

Where will our 16 year old son with severe autistic disorder and profound developmental delays live as we grow older and eventually die?  That is the biggest question I face, the question that I have to keep out of my thoughts each day, as we try, as best we can,  to help our son enjoy life while he is with us and in order to help him prepare, again as best we can, for the future.  For me,  the story of autistic 19 year old Toronto area teen Miles Kirsh told by Toronto Star Social Justice Reporter  Laurie Monsebraaten in the article Frantic parents search for housing for severely autistic son   is a story I understand very well.

As reported by Monsebraaten Miles Kirsh was diagnosed with autism at age 2. That is the same age our 16 year old son was diagnosed with autism. I suspect that Miles Kirsh's early age of diagnosis for that time period probably resulted, as was   the case with our son, from the severity of his autism disorder and its related challenges:

"Miles was diagnosed with autism at age 2. His parents largely cared for him on their own until adolescence hit and the family could no longer manage the growing boy’s often self-injurious behaviour and insomnia. Just after Miles turned 16, Kirsh asked the network to find residential care for him.

When he was a teenager, she drove Miles from the family’s Thornhill home every day to another specialized school at Yonge and Eglinton.
But Miles’ dangerous behaviour in the car to and from school —banging against the window and grabbing the steering wheel — combined with mounting family expenses and his tendency to wander unattended, prompted Kirsh to reach out."

Our son Conor has, at times, engaged in almost identical behaviour to Miles Kirsh as reported in the Star.    Our focus, to date, has not been on moving Conor out of our home. He has been a great joy for us notwithstanding the challenges he presents and I would guess the same to be true for Miles parents notwithstanding  their  separation  from the stress of the severe autism challenges of their son. 

The Star goes on to report the desperate need, in Toronto and across Ontario, for housing care for autistic adults.  The Star could have easily added "and in New Brunswick" and it would have been very accurate.I have,  both as an Autism Society New Brunswick representative and individually as Conor's dad, advocated over the past decade, without any measure of success, for the establishment of a severe autism adult care facility here in Fredericton near our autism expertise at UNB and at the Stan Cassidy Centre.  We have a general group home system that lacks the ability to provide care for severely autistic adults who are left to reside in psychiatric hospital facilities.   

The lack of government responsiveness to the need for adult autism facilities can be attributed generally to the financial challenges governments face.  Here in New Brunswick though we face another obstacle, a non-elected unofficial branch of government, the New Brunswick Association for Community Living. The NBACL  imposes its inclusion and community cliches on all public discussions and decision making processes necessary to arrive at real, evidence based solutions to the challenges facing the most severely affected by intellectual and developmental disorders. People like the autistic youth who was housed temporarily on a youth prison facility, people like the autistic adults who are sent out of the province, even out of the country to facilities like Spurwink in the State of Maine, people like those living in the psychiatric hospitals do not show up in the "feel good" PR activities of NBACL.  Here in NB we receive incessant lectures about "community" and "inclusion" but we don't have a modern  residential care and treatment facility that could provide care for adults with severe autistic disorders.

Professor emeritus (psychology) and practicing clinical psychologist Paul McDonnell has been a leading light in educating New Brunswick parents and officials about  autism disorders and evidence based effective means of treating autism disorders.  He provided his insight into what New Brunswick needs in a CBC online article Autism services needed for N.B. adults:
"In the past we have had the sad spectacle of individuals with autism being sent off to institutional settings such as the Campbellton psychiatric hospital, hospital wards, prisons, and even out of the country at enormous expense and without any gains to the individual, the family or the community," he said.

Enhanced network

Among the reforms that the UNB professor is calling for is an enhanced group home system where homes would be connected to a major centre that would develop ongoing training and leadership.

The larger centre could also offer services for people who have mild conditions. But, he said, it could also be used to offer permanent residential care for individuals with more severe diagnoses.

"Such a secure centre would not be based on a traditional 'hospital' model but should, itself, be integrated into the community in a dynamic manner, possibly as part of a private residential development," he writes.

"The focus must be on education, positive living experiences and individualized curricula. The key to success is properly trained professionals and staff."

Miles Kirsh and his parents are facing a very uncertain future right now in Toronto. Where will he live? Where will he receive the care and treatment he needs? That uncertain future is very much a problem facing Conor Doherty and his parents too. Severely autistic adults in Ontario and New Brunswick all face very, very uncertain futures.  

Does a Canadian society that brings criminal prosecutions against parents who do not provide proper care for their children not really care about some of those children, children with severe intellectual and developmental disorders,  when they become adults? As a parent I can not accept that possibility, I have to believe that Canadians care, that our elected representatives care, and that we must continue to highlight the problems faced by adults with severe autism disorders and continue to advocate for long term care solutions. We have no choice.

Dear Premier Alward: A Request for Adult Autism Care in New Brunswick


Photo by Harold L Doherty, May 20, 2012


Dear Honourable Premier, Honourable Ministers and all other respected recipients:

The subject of this post New Brunswick STILL Needs a Modern Adult Autism Residential Care and Treatment Facility is the title and subject of a comment on a blog I have operated for the past six years, Facing Autism in New Brunswick. Apart from operating that blog I have been active for 12 years in autism advocacy in New Brunswick for the simple reason that I have a son Conor, now 16, who is severely autistic with profound developmental delays. As a former Autism Society New Brunswick president and long time spokesperson for the Autism Society I participated in many meetings and proceedings with officials of both the Lord and Graham governments on early intervention, education and adult care issues affecting autistic persons in New Brunswick. Under both of those governments people in NB saw substantial gains in early intervention and education, to the point that two American autism experts, David Celiberti and Eric Larsson, reviewed and recognized NB as a model that should be considered by other provinces for replication in their jurisdictions.  In adult autism care, however, no significant gains have been made over the past dozen years. Group homes with untrained staff are still the norm.  The alternative, for more severely affected autistic adults, people with conditions very similar to my son, is a life spent in psychiatric care at the Restigouche hospital or even in a general hospital. 

I ask that you all open your minds to the realities confronting adults affected by autism in New Brunswick some of whom, like my son, will require life long residential care and treatment.  Several years ago a youth was housed temporarily in a facility on the grounds of a youth correctional centre in Miramichi.  A variety of other ad hoc solutions including exporting our autistic adults out of province, and even out of the country, to Spurwink in Maine, have been implemented at substantial financial cost and emotional cost to the autistic persons and family members involved.  A permanent, modern and professional solution has been badly needed for many years. Simply repeating phrases an cliches like "community" and "inclusion" endlessly will not solve the problem.

A coherent, rational and expert informed opinion has previously been proposed, but never acted by any NB government.  Paul McDonnell, a UNB Professor Emeritus, Psychology and practicing clincial psychologist helped educate the parents of autistic children who advocated for the early intervention and autism specific services which were enjoyed during the Lord and Graham eras.   On the CBC website in September 2010 he offered a proposal to improve NB's adult autism care and treatment needs.  I posted it on my blog comment cited above and do so again:

"We need an enhanced group home system throughout the province in which homes would be linked directly to a major centre that could provide ongoing training, leadership and supervision. That major centre could also provide services for those who are mildly affected as well as permanent residential care and treatment for the most severely affected.Such a secure centre would not be based on a traditional "hospital" model but should, itself, be integrated into the community in a dynamic manner, possibly as part of a private residential development.The focus must be on education, positive living experiences, and individualized curricula. The key to success is properly trained professionals and staff."


To Paul McDonnell's comments I would add that if this government, or the next, wish to consider the model he proposes including the secure centre for the long term care of the severely autistic and for a source of expertise for the community based homes for less severely impaired autistic adults then Fredericton is the only viable location.  I say that not because I live here at this time. I have lived in many places across Canada as a former "army brat" and as an adult. I travel around NB regularly as a labour lawyer. The Autism Society considered the location of such a centre many years ago and conducted a survey picking Fredericton for the following reasons:

1. Access to NB's autism expertise which is primarily located in Fredericton.
2. Fredericton can provide bilingual service as shown by the UNB-CEL Autism Intervention Training Program itself which provides to both official language groups. 
3. Central location.  Locating in a corner of the province does not assist families around the province in visiting with autistic family members receiving temporary care or residing in a professional autism centre.

To the reasons previously considered by the ASNB I would add a 4th personal reason.  Fredericton enjoys throughout the city a very "green" natural environment and trail system ideal for inexpensive, healthy, walking recreation of all persons including those severely affected by autism disorders. My son and I have benefit tremendously from this incredible resource. 

Autism is shorthand for Autistic Disorder and related neurological disorders which next year will be combined and known as Autism Spectrum Disorder (ASD) in the revised DSM-5 Diagnostical and Statistical Manual of Mental Health Disorders.  The Centers for Disease Control in the US, a highly respected authority, estimates that the numbers of persons with ASD is approximately 1 in 88. 

As the father of a son with severe ASD, I ask that this government begin work as soon as possible to provide a center with professional expertise as described by Professor Emeritus Paul McDonnell, one that can provide expert assistance to the community based group homes around the province.  This has been discussed for over a decade.  New Brunswick adults with autism can not afford to wait another decade before action begins to be taken.

Respectfully,

Harold L Doherty 
Fredericton NB 

cc. media, Facing Autism in New Brunswick

New Brunswick STILL Needs a Modern Adult Autism Residential Care and Treatment Facility


Restigouche Regional Hospital, Campbellton New Brunswick


Centracare Long Term Mental Health Services Center, 
Saint John New Brunswick


New Brunswick adults with severe autism disorders need an alternative to the Centracare and Restigouche hospital models as recommended by NB Autism Expert Paul McDonnell in a 2010 CBC Analysis :

"We need an enhanced group home system throughout the province in which homes would be linked directly to a major centre that could provide ongoing training, leadership and supervision. That major centre could also provide services for those who are mildly affected as well as permanent residential care and treatment for the most severely affected.Such a secure centre would not be based on a traditional "hospital" model but should, itself, be integrated into the community in a dynamic manner, possibly as part of a private residential development.The focus must be on education, positive living experiences, and individualized curricula. The key to success is properly trained professionals and staff."


A young Saint John New Brunswick woman has, thankfully, found a new home in a special care facility as reported by CBC in Autistic Saint John woman finds new home. The article indicates that the young woman's mother is relieved but is still concerned about her daughter's future.  The mother's concerns are similar to my own concerns about my son and severely autistic adults in New Brunswick.  Everyone should be concerned.  New Brunswick governments, both Liberal and Conservative, have pretended to deliberate on this issue for years without providing a real solution for the long term residential care and treatment needs of adults with severe autism issues.

There is a reference in the article to the review of youth mental health needs by former Ombudsman Bernard Richard.  What the article does not address is the fact that Mr. Richard and his advisers at the Office of the Ombudsman refused during the review in which I participated to give serious consideration to the possibility of recommending that the government establish a facility for the permanent residential care and treatment of youths and adult with autism disorders.  The need for such a facility has been highlighted by stories similar to the young SJ woman's story for many years but the problem is simply ignored. 

Any attempt to discuss development of  a facility is treated with disdain by adherents to the New Brunswick Association for Community Living philosophy  that dominate New Brunswick public policy making for persons with disabilities.  Rather than find a sustainable, systemic  residential care and treatment solution  for persons with serious autism issues who can not live in group homes the NBACL dominated public policy mindset is to let severely autistic adults live in Psychiatric and other hospital wards,  live temporarily on youth prison grounds and hotels and even send them out of the country to long term care and treatment, at considerable public expense in Maine. For public decision makers who adhere to this philosophy anything is better than acknowledging that the simplistic community ideology does not provide a realistic, sensible solution for youth and adults with severe autism disorder deficits.

Autism experts have made submissions to the New Brunswick government on these issues and I have made representations as an autism society representative  to governments both Liberal and Conservative, about the need for a Fredericton based (close to NB's autism expert base) adult autism residential care facility, spoken with media and commented several times over the last decade all to no avail:

October 2005, Toronto Star

Autistic boy kept in New Brunswick jail

No other place for him to stay 13-year-old must go to U.S. hospital. No other place for him to stay
13-year-old must go to U.S. hospital
The Toronto Star, KELLY TOUGHILL, ATLANTIC CANADA BUREAU, Oct. 19, 2005
HALIFAX—A 13-year-old autistic boy now living in a New Brunswick jail compound will be sent out of Canada because there is no home, hospital or institution that can handle him in his own province.
Provincial officials confirmed yesterday the boy is living in a visitor's apartment at the Miramichi Youth Centre and will be moved to a treatment centre in Maine by November.
They stressed he is not under lock and key, has no contact with other inmates and is living outside the high wire fence that surrounds the youth detention centre.
Nevertheless, the jailhouse placement and the transfer to Maine have outraged mental health advocates and opposition critics.
"They put this boy in a criminal facility because he is autistic," said Harold Doherty, a board member of the Autism Society of New Brunswick.
"Now we are exporting our children because we can't care for them. This is Canada, not a Third World country.
"We are supposed to have a decent standard of care for the sick and the vulnerable, but we don't."
Liberal MLA John Foran echoed his concern. "This boy has done nothing wrong, is not the subject of any court order, but is in a penal institution."
Provincial officials yesterday insisted critics are misrepresenting the nature of the boy's situation and that in fact the province has done everything it can to help him.
"This individual is not being held, and is not incarcerated," said Lori-Jean Johnson, spokeswoman for the family and community services department.
"He has housekeeping, bath and a separate entrance. We are just utilizing existing resources."
Privacy laws prevent officials from discussing anything that would reveal the boy's identity, including details of his previous living situation and the whereabouts of his parents.
This much is known: He suffers from a severe form of autism and is a ward of the state, under the guardianship of the minister of family and community services. He was living in a group home until recently, but became so violent that he was judged a danger to himself and others. At a psychologist's recommendation, he was moved to a three-bedroom apartment on the grounds of the Miramichi Youth Centre, a prison for about 50 young offenders. Two attendants from a private company watch the boy around the clock, at a cost to taxpayers of $700 a day.
Johnson said she does not know any details of his care.
Doherty said the jailhouse placement and move to Maine highlight the desperate need for better services for autistic children in New Brunswick and across Canada.
He said staff at most group homes in New Brunswick aren't trained to deal with autism and don't understand the disorder.
"If you don't understand autism, things can become very bad very quickly," said Doherty, who has a 9-year-old son with the disorder.
"We have been pushing for (better facilities) in New Brunswick for several years. This is not a crisis that has popped up in the last two days. Residential care is a critical element for these people and it is not being provided."
Johnson said the provincial system of group homes and institutions that care for children and adults with psychiatric disorders and mental disabilities works for most people.
"We do have existing resources, but once in a while, there will be an exception. Here, we are looking at a very extreme case."
The boy will be moved to an Augusta, Me., treatment centre at the end of the month, said Johnson.
The centre, run by a non-profit group called Spurwink, specializes in dealing with autistic adolescents.
A Spurwink representative did not return a phone call from the Toronto Star.
Provincial officials could not detail the cost to keep the child at Spurwink, nor did they have information about why he's being sent to Maine, rather than a Canadian facility in another province.
As I am quoted saying in the 2005 Toronto Star we (Autism Society NB) had been pushing for several years for better autism care facilities here in NB.  The 2005 incident did not result in action from the Liberal government of the day.



Doherty, a lawyer, is now in the fight of his life. As Conor nears adulthood, Doherty’s greatest worry is that the province doesn’t have the proper services for someone like Conor to maintain a high quality of life when they leave the public school system. He’s afraid Conor will fall through the cracks.
“My big fear is that he will simply be put into a room in Campbellton in the psychiatric hospital without any real life to live once I’m too old or deceased.
“On the other hand, I don’t want him dumped into one of the group homes they have.
“They don’t have staff trained to help him and they don’t have enough programs to really work with someone like my son.”

Autism is a developmental disorder that affects a person’s communication and social skills. The severity of the disorder ranges from the severe form that Conor has to Asperger’s, a more mild form depicted in movies like Rainman. The Centre for Disease Control and Prevention says one in 110 children have autism.

New Brunswick provides care both in a patient’s home and in residential facilities for more than 6,250 adults under 65 with disabilities, including autism, says Department of Social Development spokesman Mark Barbour.
But Barbour admits the province needs to do more to help autistic adults.
“There is a need for more specialized services for autistic youth and adults, whose behaviours or conditions are severely impaired.
“These individuals require services and supports designed to specifically meet their high care needs.”
The province wants to build an autism residential facility, which would provide permanent care for severely autistic adults who can’t live on their own, Barbour said."

Department of Social Development spokesperson Mark Barbour's March 2011 comments about the province's desire to build a permanent care for severely autistic adults have not been followed by any subsequent public statements to indicate that the stated intention was anything more than a public relations sound bite.

June 2011 - Facing Autism in New Brunswick 


"In Autism resources in N.B. are a 'patchwork system' Jacques Gallant of the Times & Transcript has reported on the state of autism services here in New Brunswick (Canada, not New Jersey).  As Mr. Gallant reports, our early autism intervention services have received justified praise and our schools have made significant progress although much improvement is needed especially in rural schools. I am interviewed and discuss, in particular, my concerns about the wholly inadequate state of adult autism specific residential care facilities in New Brunswick.  We have group homes with untrained staff who can't accommodate the most severely challenged autistic adults and we have psychiatric hospital in northern New Brunswick far from most of our population.  Other than that we have resorted to temporary housing in hotels, general hospital wards, youth prison grounds and shipping our autistic population out of the province and even out of the country to nearby Maine.  New Brunswick needs an autism specific residential care facility, based in Fredericton, close to the autism expertise that has been developed at the UNB-CEL Autism Intervention Training program and the Stan Cassidy Centre Autism team.  The center should have a variety of configurations and buildings to accommodate the differing needs of the range of autistic adults on the spectrum.  It should have the trained staff and quick access to the autism professionals in Fredericton to help provide continued adult education, recreation and life enjoyment opportunities for autistic adults in New Brunswick. " 



Costs have always been a challenge in establishing a permanent residential care facility for New Brunswick adults with severe autism.  That is a given and always will be.  There are however serious costs associated with the failure to build such a facility.  The primary consideration blocking the establishment of a residential care facility in Fredericton where autistic adults could receive some expert autism care during their adult years has been the overwhelming domination of social policy decision making by the "community", "inclusion" mindset of the NBACL and its partners in government.  It is simply not possible for those who subscribe to that belief system to consider alternatives. 

During the last election UNB Psychology Professor Emeritus and Clinical Psychologist Paul McDonnell, New Brunswick's foremost autism expert, who has done more for autistic children and adults then anyone else in the province commented on CBC about the need for an adult autism residential and treatment facility:

September 2010, CBC, N.B. can be a leader in autism services (Analysis, Paul McDonnell)


"Our greatest need at present is to develop services for adolescents and adults.

What is needed is a range of residential and non-residential services and these services need to be staffed with behaviorally trained supervisors and therapists.Some jurisdictions in the United States have outstanding facilities that are in part funded by the state and provide a range of opportunities for supervised and independent living for individuals with various disabilities.The costs of not providing such services can be high financially and in terms of human costs. As a psychologist in private practice I know there are large numbers of older individuals who are diagnosed later in life with Asperger's Syndrome that have no access to professional services of any kind.

In the past we have had the sad spectacle of individuals with autism being sent off to institutional settings such as the Campbellton psychiatric hospital, hospital wards, prisons, and even out of the country at enormous expense and without any gains to the individual, the family, or the community.
We can do much, much better.

We need an enhanced group home system throughout the province in which homes would be linked directly to a major centre that could provide ongoing training, leadership and supervision. That major centre could also provide services for those who are mildly affected as well as permanent residential care and treatment for the most severely affected.Such a secure centre would not be based on a traditional "hospital" model but should, itself, be integrated into the community in a dynamic manner, possibly as part of a private residential development.The focus must be on education, positive living experiences, and individualized curricula. The key to success is properly trained professionals and staff."


The  realities facing severely autistic adults in NB have been clear for many years.  Periodically those realities show up in, usually unpleasant, media reports.  Our governments however have simply chosen to ignore those realities.  They are stuck, not on financial costs but on their ideological mindset, the refusal to implement a system as described by Professor McDonnell.  New Brunswick's autistic adults need a centralized, adult facility in Fredericton close to our autism expertise which could provide permanent residential care and treatment for severely autistic adults and could provide expert assistance to autism specific adult group homes, operating with autism trained staff, in communities around the province.   Such a system would actually address the adult care realities that surface periodically in media reports and help New Brunswick's severely autistic adults live and enjoy their adult years.  

Justice? Severe Adult Autism Reality In California

Kim Oakley author of  Autism, Epilepsy and Self-Injurious Behavior has broken the autism feel good cliche glass, again, in No Justice for Severely-Autistic Adult in California a comment about Van Ingraham "a severely- autistic man who had his neck broken in 2006, while living at Fairview Hospital, one of California’s Developmental Center’s that serves the forgotten population of adults with severe autism and behavioral issues."   Oakley's comment highlights  excerpts from a report  titled Basic police work ignored in autistic patient’s suspicious death by Ryan Gabrielson published February 24, 2012 on California Watch,  Founded by the Center for Investigative Reporting.


The suspicious circumstances of Van Ingraham's death as reported on California Watch is not easy reading for me as the parent of a severely autistic 16 year old son.  The pictures posted with the report are also very moving.  I am sure it is not easy for Kim Oakley as the parent of a severely autistic son to provide her comments but she does so and her thoughts should be read and considered by anyone facing similar challenges, including public authorities responsible for caring for severely autistic adults. 


I strongly recommend both the California Watch report by Ryan Gabrielson and the comments on the report by California autism advocate Kim Oakley who never shies away from highlighting the challenges faced by those living with severe adult autism realities.  One point emphasized by Kim Oakley is the need for hidden surveillance in ALL rooms of institutions for those living with severe adult autism realities.  Without surveillance there is little way of knowing what happens to a severely autistic adult who dies or is injured under suspicious circumstances.


I commented on August 19, 2007 on a Newsday report of a severely autistic adult woman who was severely beaten by attendants who were only caught after the assaults were captured on video cameras. The Newsday report stated:


"Newsday, August 18, 2007

An autistic resident of a Long Island group home was beaten with a shoe and a wooden coat hanger, slapped in the head and kicked by several employees whose vicious assaults were captured by a hidden video camera, Nassau County police said.

The helpless 50-year-old victim was battered repeatedly at the PLUS Group Home Inc. by at least four employees after one of their co-workers alerted police to possible mistreatment of the residents inside the Uniondale facility, police said.

Group home management then installed the camera inside air conditioning vents at the home, according to Terri Cancilla, executive director of the PLUS Group Home Inc.

...

Authorities said the victim can not speak or convey emotions or pain because of her disease, which is characterized by impaired social interaction."



In my 2007 commentary on the Uniondale facility assaults I made the observation that:


"This poor soul could not speak for herself. And the animals who savaged her knew it. Perhaps video cameras in all areas of institutions with non communicative residents should be mandatory. So that the videos can speak for them when they are subject to abuse."

I agree with Kim Oakley.  Video surveillance should be mandatory in all rooms and areas of facilities providing residential care for persons with severe autism and other communication challenges.  If they were mandatory in California before Van Ingraham died he might be alive today.  

Autism Woe Canada: From Coast to Coast, No One Stands On Guard for Canadians with Autism Disorders


Two news reports show all too clearly that no one stands on guard for autistic children, youth and adults in Canada:

EDMONTON — A 51-year-old Edmonton man has been sentenced to seven years in prison for abuse and neglect of his teenage autistic son that left him looking like a "concentration camp victim." Vancouver Sun, Postmedia News, October 18, 2011 

Leave the Wild Rose province of Alberta and head to Canada's Ocean Playground in Nova Scotia and things don't get much better for Canadians with autism disorders.

"The provincial government has suspended Braemore's licence and replaced its executive director. The Cape Breton District Health Authority's board of directors is now acting as the interim board for the home.

The review was ordered by the province's Department of Community Services in February after officials found that an autistic resident of Braemore was locked inside a constantly lit room for 15 days last fall.

Minister says she feels 'absolutely terrible'

At the time, Community Services Minister Denise Peterson-Rafuse said the review was needed after her department concluded the 20-year-old man, who was allowed out occasionally for exercise and meals, sometimes urinated in the room when he couldn't leave to use a bathroom. The home's executive director, Debra MacPherson, later apologized.

Peterson-Rafuse, who was in Sydney on Tuesday to meet with the interim board, said she was taken aback by the report's findings.

"I accept the responsibility as minister to say that we could have done better too," she said in an interview."  CBC News, October 28, 2011"

A father in Alberta doesn't see what the fuss is all about over his failure to provide a humane level of care for his autistic son.  In Nova Scotia a government Minister is "taken aback" and, golly gee whiz,  she is just all shocked and surprised to see that a group home which is supposed to care for its residents didn't care at all and put adult squabbles and interests ahead of the dignity and well being of an autistic resident. 

Other Canadian provinces are no better.  Here in New Brunswick we have twiddled our thumbs and stuck stubbornly with an adult care system that does not provide safety, security and a dignified life for its autistic residents.  Adults who   suffer from severe autism disorders are sentenced to spend their lives in a psychiatric hospital. No one, including an Ombudsman's Office that has done little to help autistic children and adults in New Brunswick, will do anything to provide a decent life for the autistic adults in the care of the government once their parents succumb to old age and death. 

Our Supreme Court of Canada reversed decisions by a British Columbia trial judge and three BC Court of Appeal justices and put deference to government decision makers ahead of the best interests of autistic children in the Auton Case. Our federal governments under both Liberal and Conservative Prime Ministers have done nothing to provide Canadians with a Real National Autism Strategy.  

A Real National Autism Strategy is needed to ensure that regardless of where autistic Canadians live in this country they will be able to live in decent, humane conditions.  If we can't we should stop parading around the world, with a holier than thou attitude,  lecturing others about the way they treat their citizens.

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