11.01.2022

My Comment to the October 2022 Interagency Autism Coordinating Committee Meeting

If you're frustrated about the state of government support for autistic people and their families in the United States, one of the most straightforward ways you can speak up about autism policy is to submit a comment to public IACC meetings. What is the IACC, you ask? From their website:
The Interagency Autism Coordinating Committee (IACC) is a Federal advisory committee that coordinates Federal efforts and provides advice to the Secretary of Health and Human Services on issues related to autism spectrum disorder (ASD). Through its inclusion of both Federal and public members, the IACC helps to ensure that a wide range of ideas and perspectives are represented and discussed in a public forum. The committee reconvened in July 2021 to begin a new session under the Autism CARES Act of 2019.
Every single comment submitted goes on the public record, which can sometimes be ...not a plus because people can and do submit conspiracy theories as well as expletive-filled rants, meaning that the official versions of said comments end up being a series of black redacted bars. But the IACC really does appreciate and take notice of legitimate comments.

I try to submit comments only sporadically because I don't want to be perceived as a gadfly, but it's hard to hold back when the reality is that people either openly (or cluelessly, or misguidedly) working against better futures for autistic people like my son submit the most comments. I did submit a comment for last month's meeting, and the IACC kindly invited me to speak on the record during the meeting (the video and transcript are forthcoming). Here is what I said, much of which I have said before in other arenas but which bears repeating.

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I am writing to you both as the parent of an autistic adult who requires full-time support and supervision, and as the senior editor of Thinking Person's Guide to Autism, which is an autism research and advocacy community with large and active Facebook and Twitter communities—which I moderate. This means that, all day long, I hear from parents, autistic people, professionals, and researchers about their priorities for autistic people to live safe, healthy, fulfilled lives. 

I also participate in several initiatives for best health care practices for patients with neurodevelopment disabilities, in which participants discuss many of the same themes but in more formal ways. The lists of concerns are endless, but priorities include:

  • Research on how autistic people can process medications differently than non-autistics. The medical community seems largely unaware that autistic people often have paradoxical or atypical reactions to commonly prescribed medications, such as not reacting to—or being overstimulated by—drugs classified as sedatives. In the worst case scenarios, this lack of knowledge can be (and has been) fatal. 
  • Research on why sedation for medical care is an access need. Many autistic people, whether they can communicate effectively in medical scenarios or not, require partial or full sedation to be able to tolerate medical procedures such dental exams and MRIs. Yet this type of sedation is rarely covered by insurance. Research demonstrating the necessity of sedation in these circumstances would not only lead to more access to health care but to better health care outcomes.
  • Research on competing sensory access needs. Autistic people don't only have sensory systems that differ from non-autistic people, they often have sensory systems that differ from each other. We need research that demonstrates, for example, why it is not sufficient to hand every student with an autism diagnosis a set of noise-canceling headphones (many autistic kids can't tolerate wearing them, others can still hear disturbing noises when wearing non-professional-grade versions), and it is certainly not appropriate to put autistic people together in classrooms, or other settings, without fully evaluating and accommodating their individualized sensory profiles.
  • Research on improving access to autism diagnoses across age, gender, class, and racial gaps. Too many autistic people are being misdiagnosed, categorized as having "behavioral disorders," resorting to self-diagnosis, or being overlooked altogether. They are suffering as a result, leading to avoidable anxiety, depression, isolation, poverty, and suicidality.
  • Research on the transition from the school system to the adult world, especially for autistic people with the highest support needs. "The Cliff" is a real thing for students like my son, who is currently facing a complete lack of programs that can enroll an autistic adult with full-time support needs. Even those programs that are *in*appropriate for him currently have interminable wait lists. To compound matters, even though we are fortunate to have funding for home aides, there is currently a shortage of such workers, to the point where my son does not have the staffing he needs and deserves (and has been allocated). If families like ours, which have the language, class, and cognitive advantages that make it easier to navigate often labyrinthine and impenetrable public disability supports systems like Regional Center respite, SSI, and IHSS, still can't find any support, then families that don't have our advantages are certainly worse off.

A final note: I am gladdened about the IACC's current membership, inclusive as it is not only of autistic adults, but of autistics who use AAC to communicate, who have intellectual disability, who are parents, who have family members with intensive support needs similar to my own son, and/or who are people of color. It is hard to have faith in an advisory body that does not resemble the population for whom it is responsible, and it will be useful to see future iterations of the IACC reflect the autism communities to an even greater degree. Also, as someone whose autistic son has limited language, it is important for me to know that autistic IACC members—people who understand my son's life experience in ways that I as a non-autistic person never can—are looking out for his interests as a human being.

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If you want to start submitting comments but need reminders about the submission periods, you can sign up for email notifications at the bottom of the IACC meetings page. I really hope you start participating!

My son, hiking on a blue sky cloudy day.
My son, hiking on a blue sky cloudy day.
 

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