Why Won't The Autism Society Rein In Jill Escher's Bigotry?

I remain dismayed over how San Francisco Autism Society (SFASA) president Jill Escher comports herself in that role: She is openly contemptuous to many of the autistic people the Autism Society of America's (ASA) Guiding Princples direct her to serve, and misuses her leadership position at the SFASA to promote her personal opinions on, authorship, funding, and promotion of questionable autism science. And recently, she veered into outright bigotry at a talk at the International Meeting for Autism Research (IMFAR), which was then published on the SFASA site.

Though I contacted Autism Society of America president Scott Badesch about my concerns last year, nothing but platitudes resulted. As Escher shows no signs of tempering her harmful approaches—and in fact responds to criticism of her actions with claims of being bullied or censored—I am now asking other people (i.e., you) to let Mr. Badesch (sbadesch@autism-society.org) know that Ms. Escher's actions are not acceptable, and that they reflect badly upon the Autism Society as a national organization.

In your message, I encourage you to focus on three recent examples of Escher's questionable actions from the SFASA site:

1. Using racist and ableist graphics and phrasings 
2. Framing autistic people as burdens instead of human beings with legitimate needs
3. Claiming to be bullied by "neurodiversity advocates"

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1. Using Racist and Ableist Graphics and Phrasings

Escher's recent pre-IMFAR UCSF conference talk, which was her standard apocalyptic shpiel based on carefully massaged data about an autistic tidal wave swamping the lifespan services system (which, yes, we don't have enough services, but how about demanding that autistic people deserve to have their needs met, instead) included the graphic below. She then posted the text of that talk on the SFASA site, using this graphic yet again:

[image: White slide with black text reading, "How do we get there?
Not by drinking more autism Kool-Aid",
an image of a red Kool-Aid Man holding up a pitcher of Kool-Aid
with red text reading, "Oh, yeaaaah" over his head,  and saying,
"Autism be just quirky peeps, and there's no true increase anyway."]

How could UCSF, IMFAR, and the SFASA all allow something so offensive, with such overtly bigoted themes, to slide? I guess for the same reason that people usually don't stand up when they encounter bigotry in polite or professional society: It makes them uncomfortable, and confronting people is hard, and maybe someone else will do it.

So, OK, I'll do it: Here is why this graphic needs to be removed immediately (some reasons excluded, for brevity):

"Autism be just quirky peeps." This phrasing is either making light of African-American Vernacular English phrasing, or of people with speech difficulties. Neither one is acceptable.

Coupling this phrase with Kool-Aid imagery—as associated with bigoted African American stereotypes as fried chicken and watermelons—is making matters worse two ways: implying that African American autism community members are less intelligent because they believe what mainstream scientists tell them about autism rates, and reinforcing why African American families too often feel unwelcome in the mostly white-dominated autism communities.

I do realize Escher probably never considered that she was committing several racist fouls, but that doesn't mean her actions aren't racist. Racism is like traffic law; violations don't require intent. And I am going to say this right now: If she gets defensive about being accused of racism instead of apologizing for her missteps—even if they were due to thoughtlessness—that tells us even more about her lack of suitability for an unchecked leadership role.

"...just quirky peeps." I've already written about how dangerously ignorant and ableist (again, bigoted) this position of Ms. Escher's is, but here's a refresher:

"...as Ms. Escher has described herself as a “science junkie,” she must be aware of the research indicating that autistic people have dramatically higher-than-non-autistic suicide rates. When an autism organization official who is supposed to be in service to the autistic population dismisses legitimately autistic people as merely “quirky” – when many of those autistic people’s lives never made sense until they received an autism diagnosis, and who don’t feel like they fit anywhere except in the autism communities – she is compounding the feelings of isolation, alienation, and depression that contribute to those elevated suicide rates."

Also, mainstream science has been very clear that the increase in autism prevalence is mostly due to better identification and changes in diagnostic criteria, as documented by Tara Haelle at Forbes:

"The idea that increases in autism rates reflects changes in diagnostic definitions rather than a real change in the developmental condition's prevalence is not new. Other recent studies have found similarly that real rates of autism have not changed significantly over the past couple of decades, and a 2013 study found that identified autistic children "clustered" where resources for diagnosis and treatment were greater. In other words, where there's more access to diagnostic services, the autism rate is higher."

Impatience with mainstream science is understandable; autism research is still not doing enough for autistic people and their families. But Ms. Escher's responsibility as SFASA president is to improve lives and resources, not to force-feed SFASA families her alternative autism facts. Besides, when it comes to people scoffing at mainstream science and then self-funding and promoting their own version of autism science reality, we need to be careful. Because you know who else used a combination of pay-to-play research and catastrophizing to strike terror into people's hearts about the autistic people who have always been here? Andrew Wakefield and his anti-vaxxer faithful. We don't need any more misdirections in autism science in general, and we certainly don't need it coming from one of the organizations that is supposed to be have our community's backs.

2. Framing Autistic People as Burdens

I consider it horrifying that Ms. Escher continues to contribute to social alienation and fear of autistic people like my son and her own, most recently by compare autism to a "huge, gaping wound." Even Autism Speaks has abandoned such hyperbolic approaches.

My own autistic son, like Escher's, currently requires 24/7 support, and may need that care for the rest of his life. But, even considering the uphill policy battle to ensure our sons have decent housing options as adults, those young men are more likely to get the care they deserve if others see them as human beings, rather than as society's burdens.

3. Claiming to Be Bullied by "Neurodiversity Advocates"

Last month, Ms. Escher published a widely-derided essay on an "Autism Matrix" theory at the SFASA blog and elsewhere. After outrage from several quarters (including this one) about how the Matrix theory was ableist, assumption-ridden pseudoscience that used photos of autistic people without their permission, the essay was removed entirely from The Jewish Weekly, and the graphic at the SFASA version was removed and replaced with a thumbnail. And then shortly after that, the original Matrix post gained a new introduction:

"Dear Bay Area Autism Community, 

"One of the most troubling and counterproductive developments in the autism field over the past several years has been a growing virulence online aimed at suppressing and denigrating perspectives inconsistent with a particular neurodiversity view of autism. 

"The use of intimidation in lieu of mature and respectful discourse on critically important topics both polarizes and degrades our multi-faceted autism community. A culture of attack hurts autistic people as well as the many organizations striving to support them. 

"SFASA condemns bullying, and instead stands firm in defense of public discourse that explores and reveals the great many realities within the diverse universe we call autism. 

"Very truly yours, 

"Autism Society San Francisco Bay Area (SFASA) Executive Committee"

This statement is both absurd and hypocritical. Absurd because it is ... kind of the opposite of bullying when disenfranchised and historically discriminated-against groups speak out against those who try to keep them in their place and take away their rights. Women speak up when men try to belittle their concerns about or keep them out of women's health care discussions, and autistic people speak up when non-autistic people try to speak for them, while saying awful and misleading things about them.

It's also absurd because because:

Neurodiversity is the radical idea that people with different brains deserve to be treated like full human beings. #IMFAR2017

— Sara Luterman (@slooterman) May 12, 2017

It's hypocritical because Ms. Escher is in the unfortunate habit of using that very SFASA site to lambast people she disagrees with. Ms. Escher claims it is her right to criticize evidence-based analyses of autism prevalence because she finds the author's assertions "absurd, dangerous and worthy of scorn" or when writing that a critic of the SFASA's alarmist analysis of California's autism prevalence rates is both "fantasies" and "engaging in flippant distortions to support ideological ends."

Besides, when you install yourself as a public figure, you open yourself to criticism. Part of the media's job is to hold people in public positions accountable. And when someone who is supposed to be serving a community is actually going against that community's interests while trying to silence criticism from that community, that is a problem—as anyone who follows current U.S. politics understands only too well.

What Needs to Happen Next 

Again, please write to Scott Badesch of the Autism Society of America, and to the SFASA itself, and let them know: They either own being associated with the ableist, racist, and pseudoscience material Ms. Escher publishes under the banner of Autism Society, or they install safeguards and editorial review processes to ensure the ASA Guiding Principles are not mere lip service.

Autistic people and their families already have enough rampant negativity and stigma to deal with. We really don't need a parent from within our own autism community making matters worse. I understand being scared about our kids' futures. But I'm not throwing my son under the bus to get him what he needs and deserves, and I'm not going stand by while Ms. Escher tries to do it, either. 

Truly Awful Pseudoscience: Jill Escher's "The Autism Matrix"

San Francisco Autism Society president Jill Escher recently used that society's website to publish "The Autism Matrix," her opinion piece about what she considers "the autismS." Its most prominent feature is a matrix of photos of autistic people Escher has categorized: Not by any legitimate means, but instead by what she assumes their abilities to be. Reader, please know: this is not only horrifying, but also not how valid autism information works.

Since an unsuspecting Reader may also assume that being published on an official autism organization site lends Escher's "analysis" legitimacy, let me tell you why The Autism Matrix is in fact a steaming pile of hostility, hubris, pseudoscience, and ignorance.

Short Version of Why "The Autism Matrix" is Bunk

1. Once Escher took over as President of the San Francisco Autism Society of America—an organization that, under her guidance, does not bother including or working with autistic people themselves—she began to publish whatever she pleased on the org's blog. But her writings are not representative of the Autism Society's or even her branch's outlook, as per the disclaimer the national branch insisted Escher put on the blog after they began receiving complaints about her negative and misleading postings. Her "Matrix" is just a personal blog post, like the one you are currently reading.
2. The matrix is not even a matrix. It is a line plotted from the upper left corner of a grid to its lower right, illustrating Escher's incorrect assumption that autistic people with high IQs are always less disabled than people with low IQs. In reality, the combination of each autistic person's ability to demonstrate their intellectual capacity, paired with their support level, is complex and varied, and can fluctuate in an individual not only by age, but by environment and stress level.
3. The Matrix's x-axis measures "social/adaptive functioning." Social and adaptive skills are two entirely different ability sets, and conflating them demonstrates how little Escher understands about autism and autistic diversity. 
4. The y-axis cites "measurable IQ," as a yardstick for intellectual ability. However, people who understand autism also understand that researchers consider IQ a suspect means of evaluating autistic intellectual ability. 
5. The Matrix features pictures of several autistic people, plotted on the graph as to where Escher assumes they belong. Was Escher given permission to feature every last photo, plus access to all of the featured individual's evaluations? This is, at the very least, ethically-challenged speculation, and a mockery of most autism studies—which tend to legally insure the anonymity of their subjects.
6. The Matrix's purpose is to separate her high-support, non-speaking kids, and autistic people like them (e.g., my own son), into entirely different categories from lower-support autistic people. This is cruel, ignorant, and unnecessary. Every diagnosed autistic person by definition has a disability, and deserves whatever supports they need. Autistic diversity is a fact, not a cage match, while autism is diagnosed based on commonalities, not differences.
7. Escher is not an autism expert by training or professional experience. She is, like me, a parent. Attempting to pass her personal opinions off as valid by using sciencey stuff like charts and graphs is exactly the kind of pseudoscience approach used, with similar zealous sincerity, by anti-vaccination parents of autistic children.

Long Version of Why "The Autism Matrix" Is Baloney 

Example of a child of a hubristic parent
Source: Wikimedia Commons
[image: illustration of Icarus, a character from
Greek mythology, falling from the sky.]

After the way the 2016 US Presidential election worked out, I've become even more wary of people who inflame the resentments of those who feel ignored, with the goal of duping them into supporting approaches that are not in their, or their families', best interests.

I do not believe Jill Escher is working in autistic people's best interests when she publishes hooey like the Matrix. The problem is, some of the work she does at SFASA is cool and useful, and the board of the SFASA is full of great people (though, again, not any autistic people). And people tend to use those plusses to proclaim Escher as incapable of causing harm, as if humans are not by nature complex and contradictory beings. So please view this as a critique of Jill Escher's specific harmful actions.

When Escher, who is not an autism expert by any measure except her own, has the hubris to publish assumption-riddled nonsense like her Autism Matrix as a legitimate autism diagnostic supplement, she is doing a disservice to people who don't know any better—or who buy into her misinformed narrative about evil "high functioning" autistic people waging war on poor defenseless high-support children, and their families. And if you think I’m exaggerating the hate/divisiveness element, witness this Autism Matrix comment from Laurie Romanowich, which was approved by the SFASA blog moderator:

"Brilliant, Jill. This kind of clarity is desparately [sic] needed and long overdue.

"You have functionally addressed to some degree my long held concern, which I have previously discussed from a legal perspective, of the need to distinguish between autism that constitutes a disability within the meaning of the ADA statute (what I have called "ADA" autism) and autism that does not. I do not understand why those who do NOT have legally disabling autism within the meaning of the ADA statute have the loudest voice in this debate, let alone set disastrous policy for those who do."

Reading this comment is like watching someone retweet Trump on autism and vaccines: It is parroting conspiracy theories, not reality. Anyone who has an autism diagnosis also has a disability, and is therefore legally disabled according to even the most casual meaning of the ADA statute—the ADA being, of course, the Americans With Disabilities act. This is yet another bitter, misinformed variation on claiming autistic adults are "quirky fakers" who are "not like MY child."

Also: Autistic-self advocates who do policy work do so as experienced experts, in tandem with other disability organizations, on behalf of the greater good, often drawing on decades of policy history affecting people of all abilities—and to assert the rights of their own community. It is parents like Escher who come barreling in from the sidelines, with shallow understandings of policy precedents, and in ignorance of widest implications for people of different ability levels, who decide that when the current policies don't suit their personal outlook for their own children, they need to reinvent those policies.

But policy-making cannot succeed as a personalistic effort, as Trump is learning the hard way, and as Escher needs to recognize. Policy is about compromise, collaboration, and (ideally) to benefit the people policy makers don't hear from, as well as those they do. That means policy work is complicated, long-term, slogging that needs to address best practices for everyone as well as it can, even when it may not be perfect for advocates' personal scenarios. Much like the way I support the Affordable Care Act as policy, even though it has made getting insurance for my college student daughter who lives out-of-state very difficult.

Also, autistic self-advocates are not some sort of monolithic, parent-loathing bloc. Making that assumption is as absurd as lumping me in with Escher because we are both short white mothers of high-support, mostly non-speaking teenage autistic boys who go to the same school, we both have advanced degrees, we both live in Silicon Valley, we both do autism-related work, and we both lead lives of relative privilege. Even if you encountered two autistic self-advocates who shared as many traits as Escher and I do, there is no reason their advocacy approaches would be anything alike.

Escher's enabling and permitting such mass-dismissal of autistic self-advocates is not only silly, it is mean. Creating a graphic that segregates assumed low-support individuals like Temple Grandin from high-support individuals like her children—despite a brief grudging comment about low-support autistic people suffering too—is yet another of her continuous attempts to frame those low-support individuals as lacking any support needs at all. In reality far too many of those adults flail their entire lives due to such second-guessing, a staggering percentage of them end up in poverty, and few of them have functional safety nets. To be adult and autistic, whatever your measurable IQ—without the proper supports and services—is too often a life of pain, as well as one with an elevated risk of suicide. Scoffing at those autistic realities is despicable.

One of the most callous parts of the Autism Matrix post is Escher's inclusion and segregation of a "chatty young woman who has trouble keeping a job," after Escher spoke with the young autistic woman at a hockey game. As autistic writer Amanda Forest Vivian commented,

"Just the idea of this woman she's referencing, though, who sounds like she was openly and honestly talking with Jill about her struggles in life ... the idea of having been that open and friendly to someone like THAT, and having your personal experiences used against people like you, just makes me feel awful." 

As for the Matrix, itself, again: not a matrix. It is a line, from what she sees as "less disabled like I assume John Elder Robison to be" to "truly disabled like my kids." But people who actually attempt to understand or have empathy for autistic people who are not like their own children also understand that autistic people do exist in innumerable and ever-changing intersections of intellectual ability and adaptive skills. Escher just isn’t aware of and doesn’t recognize the autistic experiences that don’t fit her "us vs. them" narrative, dismissing those outside her non-matrix line as due to other co-morbid mental or physical conditions, the same way she dismisses “typers” like Tito Mukhopadhyay, and as if she were some sort of self-appointed autism cryptozoology-debunker. This is breathtaking rudeness and ignorance.

And then there's her problematic presumptions about the abilities of the people in the Matrix. I suspect many of the people she included would not be pleased about being featured, and may take issue with her assumptions about them, given (again) how autistic ability can change both temporally and situationally. And if her criteria is based on publicly available information, then I would be within my rights to create a new version of the Matrix and put her on it, based on her own public comments in autism science forums. I doubt she'd be pleased.

I don't really expect Escher to stop spewing agenda-based pseudoscience based on my critique; in my experience, she tends to frame any criticism as a personal attack. Of course, that is entirely missing the point: The problem is her actions. And I want people to understand why her actions are so reprehensible. As I wrote recently about the need to actively counter posts like The Autism Matrix:

"The reason for calling out is not necessarily to get that person to change their behavior (though that would be great); it is to make them accountable for the hurtful things they publicly endorse, and let their readers know that writing awful, misleading, privacy-violating things about autistic children in public is not acceptable.

If you have seen Escher's autism matrix post shared in any public or private groups, I urge you to share this post as well. What our community needs more of is useful information, not Escher's needlessly polarizing pseudoscience. While autism is about similarities, every autistic person is indeed different from every other autistic person. But that means they deserve tailored supports and accommodations, not being stuck in inaccurate boxes that will actually limit their access to those supports.

[April 25, 2017 7:40 AM: This post has been updated with a few clarifications and expansions.]

You CAN Choose Where You Want To Live, If You Have Autism

Photo © Serena Snowfield/Flickr. Creative Commons License
[Image: enhanced photo of a cozy cottage behind a flowery garden.]

The San Francisco Autism Society recently published a rather alarmist article on autism and housing issues written by their president, Jill Escher, titled "You Can Choose Where You Want to Live... Unless You Have Autism." Here's a characteristic excerpt:

"Almost every autism family I know is panicked about their children's futures. If we parents were immortal, it would be one thing. But we are not. We will inevitably decline into decrepitude and disease, and then die. Our children, who are often extremely intellectually disabled and in need of continuous care, will outgrow our capacity to care for them, and then outlive us by many decades.

"It's a terrifying prospect, but when it comes to autism-appropriate residential options, the landscape is not only bleak, it's about to grow bleaker. Adult autism cases are surging — California's, for example, will quadruple to about 100,000 within 20 years (and that includes just the more severe cases) — but former stalwarts of the developmental disability care system, including group homes and care facilities, are all too often closing or slowly being de-funded. For many autistic and developmentally disabled adults deemed "at risk of institutionalization" due to the severity of their limitations, this leaves only one viable alternative: private residences.

"But now even private residences are under fierce attack. Using convoluted and unlawful methods, the Centers for Medicare and Medicaid Services (CMS) is seeking to deter the development of private disability-friendly residential projects across the country by threatening to label them as "noncompliant" with vague Medicaid rules. Rules, I might add, that CMS lacked the authority to enact in the first place."

Unfortunately, this post is misleading on several points, including waiting lists, policy, and legal jurisdiction. I am worried that, because it presents opinions like "private residences are under attack" as fact, and uses outright fudging like "unlawful methods," it may influence families with limited resources to make housing plans or choices that are not in their family members' best interests.

Here is an attempt to clarify some of the post's factual errors, and and hopefully diffuse some of the panic that readers may be experiencing.

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Parents like me and Ms. Escher have every right to be concerned about the trickiness of ensuring our autistic kids with the highest support needs get the living arrangements they deserve as adults, whether we parents are able to be in their kids’ lives or not.

The official housing policy guidelines can be overwhelming and dense, and many of us need guidance to understand them. But we owe it to our kids to know what their rights really are — because I worry that people read posts like this and become terrified and lose hope, without exploring or understanding the actual options available.

Please know: there are no waiting lists in California for adults who qualify under the state’s guidelines — autistic people who need significant support in at least three areas of their lives. In other states, there are enrollment caps for people with medicaid waivers, but The Department of Justice recently issued a Statement of Interest that this may violate the Americans with Disabilities Act (ADA), so hopefully this will be addressed in other states soon.

So it’s not because the tools to create great options for adults aren’t there. And of course, it is hard work to research, learn, investigate, plan, and ensure our kids are set up with the lives they both want and deserve. The existing policies (Lanterman etc.) that allow for supported decision making and limit institutional settings mean that we have to spend time exploring and evaluating, and in some cases creating, the right environments with our children.

It’s also important that parents understand the services available for adult children to continue living at home. IHSS and other services are set up so that adult children who need full-time support can live at home, should families choose that option -- a valid and desired option for many.

The regulations Ms. Escher is concerned about are not meant to abolish group homes: people who rely on public support can still opt for the arrangement that suits them best. Rather, those regulations are to ensure that group homes aren't essentially institutional in nature – to ensure residents have private rather than shared rooms, for example. (This is important for autistic people who are particularly exuberant and/or have sensory sensitivities that make sharing a bedroom a challenge). There are far too many examples of why institutional-like settings put our beloved family members at risk of neglect and abuse.

Housing options for individuals with complex needs in this state (California) are not dwindling. And while we still need to work on getting cost-of-living increases built in, funding has increased enough to take the edge off in many cases: regional centers were recently the beneficiaries of a bill that is increasing funding to all service providers and facilities. New homes are being built. You can see for yourselves the most recent spate of awards -- in the Golden Gate Regional Center region alone, where my son and I live. Also, there is currently $15 million to help regional center service providers and vendors comply with the newest HBCS regulations.

Also, CMS's jurisdiction over the types of setting where HCBS are used is legitimate as outlined in the statute, and does in fact follow the administrative procedural act – they are not required to go through a separate notice and process comment about enforcing this rule in specific situation. Again, the idea is to ensure that HCBS funds are not used in settings that have "institutional" aspects, in keeping with the new regulations. More details: https://www.medicaid.gov/medicaid-chip-program-information/by-topics/long-term-services-and-supports/home-and-community-based-services/downloads/home-and-community-based-setting-requirements.pdf



I realize that Ms. Escher and the people who work with her on housing issues want our children have the best housing options possible when they become adults. But we owe it to those loved ones to make sure we use accurate information during the long and crucial process of securing homes that allow our adults-to-be to not merely live, but thrive.

More California State policy info:

• http://www.dds.ca.gov/HCBS/
• http://www.dds.ca.gov/FactsStats/docs/factBook_13th.pdf
• http://www.disabilityrightsca.org/pubs/PublicationsRULAEnglish.htm
• www.disabilityrightsca.org/pubs/506301Ch06.pdf

Necessary General Housing Reads:

• Autism and Adult Housing Choices: Separating Myths From Facts
• Successful Community Living for People with Developmental Disabilities