Saturday, December 28, 2019

Scottish Based Study Highlights Double Disadvantage Of Persons with Autism AND Intellectual Disabilities, Substantial Health Inequalities


Journal of Intellectual Disability Research banner

Conclusion

This is the first study to report the population prevalence of coexisting intellectual disabilities and autism, and the substantial influence this double disadvantage has on general health status, apparent across the entire life course. This highlights a group in need of wider recognition for whom resources should be focused on and planned for, informed by evidence. Staff in services for people with either of these conditions need to be trained, equipped, resourced and prepared to address the challenge of working for people with this duality. This is essential, to address these substantial health inequalities.

Conor Enjoying His Window Washer T-Shirt Christmas Gift



Conor enjoying the T-Shirt he got as a Christmas gift from his brother Brandon. In our family we know how much physical, emotional ... and social ... benefit Conor has received from Washing Windows at the Willie O'Ree Place. Many people have seen Conor and some have met with him as he did the window washing work that he loves. Many thanks to Jobs Unlimited for the good work they have done with Conor and others to enable them to make positive contributions and to benefit as Conor has done.

Sunday, December 22, 2019

Adult Autism NB 2020? Will NB Continue to Violate the UN Convention on the Rights of Persons with Disability or Will it ......

Adult Autism Disorders NB 2020? 
Proper Residential Care and Treatment?

Will NB Continue to Violate the UN Convention on the Rights of Persons with Disability of NB adults with severe autism and intellectual disabilities or Will it End the Restigouche Hospital Atrocity, close the Restigouche Hospital and start work on a Fredericton based autism centre with a village of autism specific care homes in communities around the province for adult persons with autism and a variety levels of need of autism residential care and treatment? 

I asked this question of our MLAs in November 2018.  I received no real answer to my question.   


The Ombud Report issued in 2019 "Failure to Protect" provided clear and compelling evidence that  the proposed youth mental health centre which has now been scheduled to be established in Moncton would not provide appropriate services and care.  The evidence in that report confirms confirms that the Restigouche does NOT provide proper services and is not an appropriate setting for adults with serious autism and intellectual disabilities.  

The Karissa Donkin CBC report on disciplinary issues "Violence and threats, negligence, insubordination led to discipline at troubled hospitalalso confirms that there are very serious disciplinary issues at the Restigouche which is located on our Northern border as far as possible from our larger populations and far from most NB families. The location  makes it difficult to retain professionals for the Restigouche and to maintain a disciplined, properly trained work force.

In New Brunswick very substantial gains have been made with respect to the provision of health, education and social services to persons with Autism Spectrum Disorders.  Our early autism intervention program has achieved national AND international recognition based on the excellent work of the UNB-CEL Autism program at UNB Fredericton. Teacher aides and Resource Teachers have received autism training from the UNB-CEL program and the Stan Cassidy Centre Autism team provides autism consultations up to age 19. NOTHING however has been done to provide for professional, decent, humane autism residential care and treatment for adults. 

Paul McDonnell Ph.D., and a Canada wide leader in developing evidence based autism treatment,  was a key player in establishing the program which forms the basis of these services and he also, in consultation with parent advocates, developed the NB Autism Spectrum Village Proposal which was presented to the Gallant Government, then Social Development Minister Cathy Rogers, in 2015.  The "Village Proposal" would provide for the establishment of an Autism Centre in Fredericton, the home of NB's current autism expertise and centrally located. The centre would provide training and oversight for staff in homes around the PNB close to families in all parts of the province.  It would also provide, from its central location, permanent residential care for those most challenged by autism and related conditions. 


Wednesday, December 18, 2019

Paul McDonnell - 2010 - Adult Autism - What NB Needs Now 2010 - 2020

Adult Autism: What NB Needs - Paul McDonnell September 2010 ( will still be true in 2020 HL Doherty):
"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 behaviourally trained supervisors and therapists. 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 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."



Thursday, November 21, 2019

“Thoughts on Dr. Ivar Lovaas from a Parent” Written by Harold Doherty for the ASAT


Dr. Ivar Lovaas
photo from the Association for Science in Autism Treatment
His truly ground breaking research provided the evidence basis to prove the effectiveness of Applied Behavior Analysis as an autism disorder treatment.
Neither I, nor any of the other NB parents who advocated for evidence based autism services, the early autism intervention program,  teacher aides and resource teachers trained in autism and ABA principles, reversal of the decision to close the Stan Cassidy Autism team and the as yet unrealized autism village network and center were invited to speak at the recent Atlantic Provinces "High Functioning" Autism Conference at UNB Fredericton even though some including me live within walking distance of the Conference location.  We were not always treated with such disrespect though, our childrens' voices were able to be heard directly with our help.  Recognition came from different sources including the Association for Science in Autism Treatment which asked yours truly to offer commentary on the great Dr. Ivar Lovaas who contributed so much to the lives of children with autism spectrum disorders. 

“Thoughts on Dr. Ivar Lovaas from a Parent”
Written by Harold Doherty
I never met Dr. Ivar Lovaas in person. My 14 year old son, Conor (diagnosed at age 2 with Autistic Disorder and profound Developmental Delays), was never a patient or a subject in a Lovaas study. Yet, when Dr. Lovaas passed away recently I felt that one of the most important people in my son’s life had been lost. Through his career and research he helped our family, our teachers, and autism service providers, teach my son and other children with autism. He proved to us that we could help children with autism learn to communicate, to overcome deficits, to grow, and to live more rewarding lives.
The importance of Dr. Lovaas in my son’s life stems from his research, reported in 1987 and 1993, which demonstrates that Applied Behavior Analysis (ABA) can help many children with autism overcome the cognitive, linguistic, and behavioral deficits which are often displayed in these children. Unfortunately, I cannot provide testimonial evidence that my son Conor, who is severely impaired by his disability, has recovered from autism because of ABA. This is partly because such services were not readily available in Fredericton (New Brunswick, province of Canada) where we lived at the time when Conor received his diagnosis. I did not learn about ABA until Conor was almost four years old, when the preschool development window was already closing for him. Therefore, he did not have the opportunity to receive 40 hours per week of discrete trial training between the ages of two and five. Notwithstanding the severity of my son’s condition, and his late introduction to the ABA principles that Dr. Lovaas demonstrated, he has been helped immeasurably by the effective autism intervention created through this research.
Dr. Lovaas’ work helped convince this father that ABA was the best bet on which to gamble my son’s valuable development time. That research provided me and my wife, Heather,with the confidence and the methods to help us communicate with our severely autistic son, and help him grow and develop. As parents, few gifts are greater than these. My knowledge of Lovaas and of ABA began when I attended lectures given by a clinical psychologist and University of New Brunswick (UNB) psychology professor emeritus, Paul McDonnell, PhD, who worked with children with autism and educated many parents about the Lovaas studies and about ABA principles in general.
In particular, Dr. McDonnell gave a lecture entitled, “Managing Problem Behavior in Autistic Children.” It is the only talk from the many, varied, and bewildering seminars given by various purported authorities in those early years that I can remember with any detail. It was the only presentation at which I was made aware of learning principles that would be helpful in dealing with the serious challenges a parent faces in raising a child with autism. I can still visualize a “Problem Behavior Extinction” Chart from that lecture, based on evidence, which showed how to eliminate problematic (including dangerous and self-injurious) behavior in children with autism. The effectiveness of ABA principles was not “pie-in-the-sky” nonsense. The claim of effectiveness was based on solid research, and in particular, on the research of Dr. Ivar Lovaas.
At the conclusion of that presentation by Dr. McDonnell, I immediately tried to use what I learned. That evening, in a crude application of ABA principles, I refused my son’s initial screaming for what I knew, from experience, was a favorite treat (an apple), until he started to ask for it by saying the word, “apple.” I repeated “apple” in two drawn out syllables, “Appp … pull.” Conor continued to scream. This process continued for almost 45 minutes until Conor finally said, “App.” I immediately gave him a bite of the apple. Each time he said, “App,” he got another bite. Then I insisted that he say “app-pull” to get another bite. After almost an hour and a half of this process, Conor had said “apple” several times, and without prompting.
This anecdote might not seem like much to many people, but to me it was the first time I was able to teach my son to say a word. It was the first time that I could communicate with him at all, in any meaningful way, other than by guessing what he was trying to say through his screaming. The process I just described was not easy for me to endure as a parent; to withhold what I knew my son wanted while he screamed in frustration. That experience, though, was the beginning of my ability to communicate meaningfully with my son with autism, and he with me. I was able to do it, I was able to communicate with him meaningfully, because the principles were sound and because I was convinced it would work. I was convinced it would work because of the research evidence in support of its effectiveness, especially the research by Dr. Lovaas.
Since that initial success there have been many others. Conor’s ability to communicate with us, and ours with him, has improved substantially. We used ABA principles at home and were successful at toilet training Conor well before he started school. Frustration-induced aggressive behavior toward others has been eliminated. Conor started his first year of high school, with his own curriculum and with ABA based instruction at school. Conor initially started school in a general classroom for the entire school day, but that resulted in some self-injurious hand-biting. It was resolved shortly thereafter by placement in a more quiet area for his ABA instruction, and the hand-biting disappeared. Otherwise, we have not had a single incident of aggression toward himself or others, nor problem behavior of any kind, reported to us by school officials. Conor loves attending our neighborhood schools, loves receiving his ABA based instruction, and is liked by fellow students and educational staff. I do credit Conor himself. Conor has always been naturally personable, and well liked by other children and adults, but his interaction with others has also been helped by the application of ABA principles to address his more challenging autism based behaviors.
It might surprise some to read that, here in New Brunswick, my son receives ABA based instruction in our neighborhood schools, but that has been the case for several years. The provincial government has provided ABA training to teacher assistants and resource teachers at the UNB-CEL Autism Intervention Training Program. The program is based on ABA principles and research, and has received external review by Dr. Eric Larsson of the Lovaas Institute who described it as “A remarkable and thorough program that has been developed to an exceptional level of quality in the context of limited resources. The province-wide model is one that many other provinces should adopt, as it carries with it many cost-effective features. The curriculum content requires little modification.”
The UNB-CEL program itself was based on ABA research, and includes instruction in discrete trial training. The program was first developed to train autism support workers and clinical supervisors for the preschool autism intervention treatment centers, established in New Brunswick several years ago, in response to intense parent pressure. It was adopted for use in training teacher assistants and resource teachers in our neighborhood schools, again after some determined parent advocacy. As parents supporting our children with autism, we were successful because we were focused, persistent, and well informed about autism and effective interventions. We also succeeded because we had the tools (the Lovaas studies) with which to convince political and civil service leaders that ABA was an effective evidence-based intervention that would help children with autism to learn.
Dr. Lovaas provided our family and our government with evidence that ABA is a powerful intervention for children with autism. He said that “if a child cannot learn in the way we teach, we must teach in a way the child can learn.” He also proved to us that it could be done, and showed us how to do it.
Harold Doherty is the former President of the Autism Society of New Brunswick, involved with advocacy for establishment of UNB-CEL Autism Intervention Training program, provision of ABA early intervention up to 20 hours per week provided by the Province of New Brunswick for children with autism between 2 and 5 years old. He currently advocates for autism youth and adult residential care systems in New Brunswick.
Citation for this article:
Celiberti D., & Taylor, B. (2010). A tribute to Dr. Ivar Lovaas. Science in Autism Treatment,7(4), 8-11.

Sunday, November 17, 2019

APAC Chose Not to Include NB Parents of Adults with Severe Autism and/or Intellectual Disability on APAC Speakers List and Their Adult Childrens' Residential Care and Treatment Issues were not Discussed at the Fredericton "APAC "Autism"" Conference

Adults with severe autism challenges and.or ID have been sent to the Restigouche hospital on the northern NB/Quebec border for decades far from families; out of sight and forgotten by government. The recent Ombud Report has confimed our fears that proper care is not provided in this location far from most NB families. This has been a serious issue in NB for many years and is referenced in the UN Convention on the Rights of persons with Disabilities.  Clearly in violation of the United Nations Convention on Rights of Persons with Disabilities articles 25 and  26.  Canada is a signatory to the CRPD including the protocol provisions which were signed on to in late 2018. 

These facts and issues were not discussed at the recent Atlantic Provinces ""Autism"" Conference ....because NB parents were not included on the speakers list by APAC or UNB CEL. I could have attended at no cost to the APAC group as I  literally live in walking distance of UNB Fredericton. I have been actively involved, as have many other NB parents, in advocating for adult autism residential care and treatment. But we were not worthy of being consulted and as a result our adult childrens' interests were not discussed at the alleged "autism' conference.



The UN Convention on the Rights of Persons with Disabilities, which has been ratified by Canada,  states in Health article 25(b) and (c) that parties to the CPRD have agreed to:

b) Provide those health services needed by persons with disabilities specifically because of their disabilities, including early identification and intervention as appropriate, and services designed to minimize and prevent further disabilities, including among children and older persons;

c) Provide these health services as close as possible to people’s own communities, including in rural areas;
(Underlining added HLD)


The Autism Society of New Brunswick submitted a request for  an Autism Village residential care and treatment network to the PNB government in 2008. 




Paul McDonnell, UNB Psychology Professor Emeritus identified adult residential care and treatment as NB's  greatest service need in a 2010 CBC Interview. 




Paul McDonnell, September, 2010

"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 behaviourally trained supervisors and therapists. 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 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 supervisionThat 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."  

(Bold highlighting added - HLD)

Professor McDonnell submitted a paper to government  in 2015 in conjunction with parents Cynthia Bartlett and myself which called for an autism village consisting autism trained staff facilities in communities around NB and a center to develop autism expertise and permanent residential care and treatment for those most severely affected by autism and related disorders. 

The issue of adult residential care and treatment however was not, according to people I have consulted, discussed at the Atlantic Provinces ""Autism"" Conference.  Given the Atlantic Provinces ""Autism"" Conferences decision to exclude NB parents of NB adults with severe autism and/or intellectual disability I am not surprised. 

It is almost 12 years since the Autism Society New Brunswick attempted to discuss the need for adult autism residential care and treatment with NB governments. We fought for NB's early autism program, UNBCEL autism trained education aides and reversal of the decision to close the Stan Cassidy autism team.  Yet almost 20 years later and many years of attempts of advocating for governments to address the needs of adults with autism for residential care and treatment NB governments still ignore those needs. 

APAC could have provided a forum for these important adult autism issues in NB and Atlantic Canada to be addressed. 

They chose not to consult us parents or invite us to speak on these important adult autism issues and I for one am not at all impressed.

Harold Doherty
Conor's Dad
Queen Elizabeth II Diamond Jubilee Medal Recipient - Autism Advocacy


Wednesday, October 16, 2019

CANCELLATION NOTICE - Protest at the Atlantic Provinces High Functioning Autism Conference Nov 8 & 9 CANCELLED

Cancellation Notice: In early August I announced my intention to protest in front of the UNBCEL hosted Atlantic Provinces High Functioning Autism Conference on Nov 8 & 9. My legal practice requirements make it very difficult at this time and I will not be protesting at the Conference.

. I was ticked off that the conference like its predecessor at Shediac focused on high functioning autism and excludes persons who can speak authoritatively about the struggles facing persons with autism and ID ... the parents, many of whom were among the parents who advocated for early autism intervention, autism (UNBCEL) trained school aides and reversal of the decision to close the Stan Cassidy autism team.
I thank CTV's Jessica Ng who was kind enough to interview me about the lack of parental participation about the Atlantic Provinces High Functiioning Autism Conference. at the Fredericton North Market with Conor.
An Autism Connections Fredericton spokes person Rick Hutchins was interviewed also and was very disappointing as he was very careful to avoid mentioning the words "Intellectual Disability". (International Estimates are that 40-50% of persons with Autism also have ID). Persons with autism and ID have exceptionally high incidence of epilepsy and face a 30 YEAR premature mortality rate compared to persons in the general population..

40-50% of the autism spectrum in NB with intellectual disability will not be represented at the Atlantic Provinces High Functioning Autism Conference.. No applause for the hosting UNBCEL from this NB father of a son with autism, intellectual disability and epilepsy who was one of the parents whose advocacy led to the establishment of the UNBCEL autism program and the continuation of the Stan Cassidy autism team.

Sunday, October 13, 2019

Conor Loves Working Hard Washing Windows and Has Benefited Greatly from Doing So





Conor's old school lunch bag below. He was accommodated outside the mainstream classroom at our request and he loved school and would often put his lunch bag on the kitchen counter to tell us he wanted to be ready for school. Today he put it up there again because he loves his activity with Jobs Unlimited especially in the mornings at the Willie O'Ree where he washes windows. He was letting me know he wanted to go to the WillieO'Ree.



When he found out there was no JU and no Willie O'Ree tomorrow because of Thanksgiving he was quite agitated at times.
Conor requires an attendant from JU with him at all times for his safety. He LOVES washing the windows at the Willie O'Ree where his physical AND mental health have prospered and the anxiety he felt in his last year of High School when he knew he was finishing school has been beaten back.
People who don't know my son's realities would expect a full pay employment relationship but that is not real with an aide required at all times and staff to maintain the organization. Conor has benefited greatly by providing the service he does as many volunteers do for charities and churches. If the extremists I heard recently at an otherwise very informative and positive disability meeting attempt to impose their will to prohibit his volunteer service he loves I WILL FIGHT THEM.

Q & A from  Facebook:

Q:  Was this the meeting Friday evening? What’s this about?

A:Yes this was the Friday evening. There was a discussion about advocating for laws to prohibit situations like my son's. There was no room for exceptions and one person got very loud and insulting and would not listen to the information I presented that Conor could not do this without a full time aide who requires payment, that my son has greatly benefited physically and mentally from being able to do this work. I left the meeting because there was no real dialogue and I am not going to sit and be told by a stranger what is best for the son I have cared for his entire life and do so every day. .The general discussion on mental health and lack of MH services was very informative and moving. But the person who was insulting could not understand that my son's mental health has benefited greatly from what is essentially volunteer work. In fact he is very happy as you can see in these pictures.


Thursday, October 3, 2019

Dear Fredericton MP Candidate Will You Advocate for Federal Funding for a New Brunswick Adult Autism Spectrum Residential Care & Treatment Village Model?

Dear Fredericton MP Candidate:

Jenica Atwin Green 
Matt DeCourcey Liberal
Andrea Johnson Coservative
Mackenzie Thomason NDP

Will you support and advocate for the New Brunswick Autism Spectrum Village Satellite Model to support Adults with Autism Spectrum Disoder as set out in this paper written by Professor Emeritus (Psychology) Paul McDonnell in 2015? The Model would include a center for care of the most severely challened who studies face a  30 year reduced life expectancy and a range of facilities including homes in communities around NB for varying  levels of persons with autism disorder challenges.


The New Brunswick Autism Spectrum Village     

It Takes a Village to Support Adults with Autism Spectrum Disorder

NEW BRUNSWICK SATELLITE MODEL FOR
ASD SERVICES FOR ADULTS

New Brunswick has made great gains in providing early intervention programmes for children with
autism spectrum disorder (ASD), a neurological disorder, and is currently developing a
comprehensive programme to train teachers and teacher assistants within the province to work in an
effective manner with our students.  To date, no initiatives have addressed the needs of adults.
Once a student reaches the age of 21 years, there are no services, no supports, and the entire
burden of support and care falls upon parents and family.

It is therefore imperative that New Brunswick establishes an Autism Treatment and Residential
Centre.  The centre should be situated in Fredericton so that it is physically close to regional
autism expertise at the UNB-CEL autism program and the Stan Cassidy Centre.  The Centre would
provide treatment for all autistic adults who are too old for treatment at the Stan Cassidy program
and permanent residential care for the most severely autistic some of whom have been sent to the
Spurwink Facility in the State of Maine and to the Restigouche Regional Psychiatric Hospital in
Campbellton.  Autism specific group homes around the province are required with autism trained
staff and oversight from the Centre.  In this sense, the model proposed could be characterized as a
“satellite” model in which the centre in Fredericton would be linked directly to a number of
satellite homes around the province.  Medical issues commonly associated with autism disorders
including epilepsy and depression would also be treated in the context of persons suffering from
autism and the extra challenges it presents to treating those common co-morbid conditions.

The scope of the problem can be appreciated when one considers the fact that autism spectrum
disorder is the single largest disability across Canada. Current estimates of the number of
individuals diagnosed with autism spectrum disorder range from the recent estimate by the Center
for Disease Control in the USA of 1 per 68 persons1  to slightly more conservative estimates around
1/1602. This means that the incidence of autism spectrum disorders ranges from 4700 to 11,100
individuals in New Brunswick.  It also means that services are needed for roughly 3,300 to 7900 are
in the age range between 22 years and 75 years.

1CDC, Prevalence of Autism Spectrum Disorder Among Children Aged 8 Years — United States, 2010,
March 28, 2014 / 63;1-21
2Elsabbagh M, Divan G, Yun-Joo Koh YJ et al.. Global prevalence of autism and other pervasive
developmental
tism Res. 2012;5(3):160–79

One can also understand the scope of this problem by looking at the following list of challenges
that are faced by parents of an adult son or daughter with autism spectrum disorder. Because the
range of disability within ASD is so broad, we present a wide range of very typical challenges that
families face.

• Cessation of Educational Opportunities – Once a student leaves the school environment in which
they have supported learning opportunities, there are few if any places a student can go to advance
their learning. Most of these students could not avail themselves of post secondary learning
opportunities, as they require a significant amount of scaffolding to enable them to succeed.  At
age 21 most typical students have a variety of skills and are reasonably literate.  Even they need
ongoing training and many even most do some form of additional education or job training.  This is
not possible for the majority of the young people with ASD.

• Unemployment – The rate of unemployment among all levels of persons on the spectrum is close to 100%.  Some do manage to find limited employment opportunities through the services of centres such as Fredericton’s Jobs Unlimited.  However, the majority of persons on the spectrum are not
successful.  It is believed that people with Asperger’s (the most functional of persons on the
spectrum) have a 75-85 percent unemployment rate.  Autism Speaks estimated that 85 percent of
adults with autism in the United States are currently unemployed or underemployed. Among young
adults between 21 and 26 years old, only 50 percent have ever had a paid job outside of their
households. This means that parents may have to support their son or daughter for most of their
lives.   There are some government supports such as the disability tax credit and the disability
retirement savings plan but we know that not all persons with a diagnosed condition will qualify
for support and even if they did, the support is minimal in comparison to a living wage.  The 40%
to 50% of persons with ASD who also have intellectual limitations are most likely to remain totally
unemployed although a few may find very limited opportunities through non profit community
agencies.  The half of the ASD population with relatively higher intellectual skills will also have
very limited employment usually because of social challenges.

 Regression of skills – All professionals who work with persons with ASD have seen the loss of
skills that results from a lack of stimulation that comes from learning in functional social
contexts.   In fact, several years ago, UCLA Psychologist, Ivar Lovaas, did a study in which
individuals who had increased their IQ scores in a three-year treatment programme, lost almost all
of the   3 functional skills (e.g., language skills, self-help skills, and cognitive skills) they had learned after three more years of no educational programming. We experience these kinds of regression frequently when an individual passes from a relatively stimulating learning environment to living at the family home without a planned curriculum.  Early intervention is the best way to provide long lasting learning but not all individuals will succeed sufficiently to be immune to regression of skills once formal training stops.

• Lack of respite Care – There are very few services available to provide respite to parents or
guardians of individuals on the spectrum.  In addition, even fewer services exist (if any) that
have staff that re appropriately trained.  This is a crucial service needed by almost all families
affected. Parents with adults on the spectrum can be in very desperate need for respite care. In
some cases, the individual with ASD will require care 24 hours a day and 7 days a week. Depending
on a family ‘s circumstances, this may mean that either a father or a mother will need to be at
home with the child at all times. In other circumstances, the needs may be different. An individual
may not require as intense care but may present with many challenging behaviours and the parents
may need short-term breaks.

• Lack of opportunity for recreation – Recreation has been shown to be an effective treatment for
many of the challenging behaviors we encounter with individuals on the spectrum.  In addition,
there is research to show that individuals with developmental disabilities tend to be less fit in
general and tend to have more illnesses.  In large measure this situation arises from lack of
suitable recreational and vocational services and far too much unstructured, idle, time.

• Restricted Social Lives – Individuals with a diagnosis are by definition less interested in
social interactions and more likely to seek solitary pursuits. The major disability in autism
spectrum disorder is a social disability.  Left on their own this pattern of behaviour intensifies
and we know that increasing isolation from healthy social interactions can lead to major
challenges.  With supports in employment and in other kinds of social interactions, persons with
ASD can enjoy and benefit from social contacts.

• Mental Illness – The research is clear.  Individuals with ASD are more likely to be affected with
co-morbid forms of mental illness such as depression.  The factors that contribute to the high
percentage of mental illness are social isolation, lack of social supports in meaningful
activities, lack of education, and lack of meaningful work and recreational activity.

• Behavioural Challenges – We need to point out that access to regular society (employment,
residential living, recreation, etc) requires a minimum of compliance and an absence of aggressive
behaviours.  Many individuals with more severe forms of ASD have some level of behavioural
challenge.   These behaviours are almost always caused by poor communication skills and inadvertent reinforcement of problem behaviours by caretakers who do not have sufficient training to handle these kinds of behaviours.

Summary of the Problem:  It is clear from the description above that families with an adult child
can be faced with overwhelming challenges and stress related to providing the very best services
they can to their son or daughter.

Solutions:  The needs of individuals and families and the scope of the problem described above canbe mitigated or overcome by our proposed centre.

Our proposed centre would not be a single building as such but rather a satellite network of homes, apartment-styled buildings and other facilities integrated as much as possible within residential neighborhoods. The design is explained in more detail below.  Our approach will be innovative and uniquely designed to suit families in the New Brunswick situation.  The key principles for this proposed village are that all programmes and services are as much as possible evidenced-based, that the centre be dynamic in the sense ofbeing flexible enough to meet diverse needs.  It also needs to have a meaningful connection to the NB community and that includes accessibility of services and easy accessibility for families to maintain a connection to the clients in the centre (or centres).

Comparative Analysis: There are some existing facilities that serve adolescents and adults across
Canada, in the USA and in Europe.  For example, in the Toronto region there is a group called
Kerry’s Place that offers evidenced based services for adults.  New Jersey has some outstanding
private facilities and in particular the model developed at Princeton Child Development Centre is
called Mountain View.  There are no services in New Brunswick that are remotely comparable to these  services.  Currently, when we have an adult with ASD that is unmanageable in a home or in existing special care homes, they are sent to a facility in Maine called Spurwink . The facility in Maine is a fine service but it costs the taxpayers thousands of dollars and is far away for the client’s family.

THE NEW BRUNSWICK “SATELLITE” MODEL: We have proposed a
"satellite" model that would provide residential and other adult services in several regions around
NB but also would have a home base located in Fredericton.  In general, the best way to provide
the physical spaces and to find appropriate staff is to make use of existing facilities but offer
upgrading and training.  There are a number of options available such as providing training and
other upgrades to selected group homes in the province. In addition, one can look at working with
selected developers to create some residential complexes for both typical individuals and persons
with special needs of various kinds.

Possibly, an autism centre can be created at UNB or in association with the Stan Cassidy Centre.  
The details of the physical spaces need to be planned carefully but the guiding principal is to 
provide dynamic services for all adults involved either as residents or as day users of the 
facilities.  As well, we want facilities that serve the diverse needs of the adult population.

SERVICES OFFERED BY THE NEW BRUNSWICK MODEL:

In a future draft of this proposal we will provide a detailed description of the kinds of services
that we envisage.  These will include at a minimum residential services, sheltered work and
vocational services, ongoing training in life skills and personal care, treatment of behavior
problems, recreational skill development, respite care for families, training of families in skills
needed to maintain their son or daughter in a home setting, and social skill development. There are
clearly levels of support needed and the following is a list of some of the more obvious levels.
Over the course of their lives, individuals may move from level to another.

•                         Independent living with assistance. Some adults with ASD are able to live
on their own. Others can live in their own home or apartment if they get help dealing with major
issues, such as managing personal finances, obtaining necessary health care, and interacting with
government or social service agencies. Family members, professional agencies, or other types of
providers can offer this assistance.
•                         Living at home. Government funds are needed for families who choose to
have their adult child with ASD live at home. These programs include some form of pension,
disability tax credits, and support for extra services. However, we know that there is a point at
which family may no longer be able to provide support at home and other options need to be
available. Training for parents needs to be available.
•                         Other home alternatives. Some families open their homes to provide
long-term care to adults with disabilities who are not related to them. A home setting such as this
type needs to provide some form of skill development such as teaching self-care and housekeeping
skills and arranging and getting involved in leisure activities.


The New Brunswick Autism Spectrum Village   

•                         Supervised group living. People with disabilities often live in group
homes or apartments staffed by professionals who help with basic needs. These needs often include
meal preparation, housekeeping, and personal care. People who are more independent may be able to
live in a home or apartment where the staff only visits a few times a week. Such residents
generally prepare their own meals, go to work, and conduct other daily activities on their own.
Once again however, training of staff is a key to success.

Long-term care facilities. This alternative must be available for those with ASD who need
intensive, one-on-one constant treatment and supervision. While this group is a minority, they
present the biggest challenge for their families who, at present, have no means to provide the
services required.

THE SATELLITE MODEL: There are good reasons to have the base for our satellite model located in Fredericton.  There are already a number of sources of autism expertise in this location.  For
example, a satellite model based in Fredericton would have would have a permanent connection to the University (Psychology, Education, Nursing) and the autism team at the Stan Cassidy Centre as well as other local health professionals.  The base would also be the home for one of the most
 important functions of our model and that is the training of staff and setting forward operational procedures and protocols.  Since 2003, the University of New Brunswick (especially the College of Extended Learning) has been a key in the development of training for staff for preschool and school-aged children to date. It has also been involved in building capacity for Applied Behavior Analysis in other jurisdictions such as Saskatchewan and has developed new programs for undergraduates at UNB as well as an open access programme.   Thus, we envisage a Fredericton-based centre that offers training and support and then a series of satellite facilities around the province that follow
service protocols developed by team at the main centre.

THE IMPORTANCE OF EVIDENCE-BASED SERVICES:  The key to success
in providing excellent services to adults and adolescents is that the methods employed are grounded
in a body of research evidence.  The philosophy of the proposed model is one that embraces growth
for all of its clients at all times.  In no way are the centres to be construed as facilities for
warehousing clients – quite the opposite. The philosophy is to keep residents and other clients
engaged in meaningful social, work, and recreational activities.   Keeping all clients learning and
actively involved in a range of activities is crucial.  All services delivered need to be held up
to the rigorous standards of evidence.

THE IMPORTANCE OF ETHICALLY-BASED SERVICES:  The second key
ingredient is that the services must have the highest level of ethics and as a

The New Brunswick Autism Spectrum Village   result we may base our model's ethical treatment on
a modification of other relevant ethics codes such as the BACB Guidelines for Responsible Conduct
or the Canadian Psychologist Association.  In the CPA code there are four basic tenets or major principles that are fairly typical of most codes.  These include:

1) Respect for the Dignity of Persons  
2) Responsible Caring
3) Integrity on Relationships  
4) Responsibility to Society

Ethically–based services will not only meet with public approval, they will be more effective.
Clearly, one of the ethical principles is that we offer clients only those interventions that are
scientifically demonstrated to work. Thus, interventions are less likely to cause problems and
clients are more likely tothrive and develop more skills and adapt more to typical life.