Selective Outrage in Autism Behavioral Health Services and how it hurts us all

A few months ago I hosted an open house. Many conversations were had with parents, community partners, and clinicians.

?One representative from a nearby ABA organization commented that children beyond age six were (in fact)accepted into their program. This statement shocked many into silence including the parent whose child was rejected because he was six. I responded to the individual referencing what had been captured by community talk. The representative then replied stating "We see clients up to age 18. It is not about age, this is about skill."

?I was outraged. Selectively so. My silent selection counted the cost of this conversation and the purpose of our meeting. I know and believe that it is harmful to prioritize skill over age. For me, it brings up the fit of service and human dignity. It's like giving a coloring book to an 60+-year-old person with aphasia for therapy. It does nothing and removes how we think of intervention and human dignity. It promotes the 'functional' propaganda that harms...

?In the conversation with the individual, I didn't say anything. I only talked to others about it. And I'm writing about it here. I told myself I was making a difference and that I would stay the course.

?Recently, many have been outraged by #KaylaPerry's podcast and the conversation about the value and worth of people with disabilities. Since Kayla is one of the speakers at a conference and I am an invited speaker, there have?been a few discussions and queries regarding my thoughts.

?I have many thoughts. First, the discussion on the podcast was an ignorant one. In my opinion, wasteful of time and energy. It was also audacious in one of the worst ways. And?symptomatic of a bigger discussion we have been unwilling to have in our field. In my mind’s eye, better discussions center on what value looks when people show up on our caseloads. This discussion would further press and quickly shift to how we have grown accustomed to intellectualizing progress rather than being more action-oriented. It would also capture the selective bias in communicating with our broadly identified leaders.

?#Dr.Nasiah ( Nasiah Cirincione Ulezi, Ed.D. ) and I spoke a few days ago about this topic. We spoke via phone and zoom. We are two people who hold both similar and differing viewpoints about various topics. Yet, we will orient ourselves to discuss issues from time to time because we are for the profession and its progress. We respect the approaches of the other and will engage in tough and honest discussions. On this topic regarding The Unpopular Conference and the #KaylaPerry podcast, we?land similarly.

?Censorship. And Cancelling people. If we are not for censorship, how can we be for it in this case?

As person(s) from historically marginalized groups, there is an understanding of what it means to deprive people of the opportunity to not listen, not engage in discourse, and ban intellectual access...to not think for themselves. Being for these freedoms, means you are for these freedoms even when disagreement happens. Selective outrage should be the title of a comedy show, not in our real life as behavior analysts and clinicians. Yet, here we are (again).?

Sure, we don't like it, but what next??Discuss it on social media… post, create pretty cool videos about dignity, and create a top 10 list. And then what?

?It's selective outrage and the cowardly protest of it all. It’s the emails and DMs saying “don’t” mixed with “duty”.?We all have an ethical responsibility to speak with people with whom challenges exist, distinguish the ‘I don’t like it’ from ethical violations, disseminate information to the public, and more. But the truth is ugly because the selective outrage, in this case, now has an identifiable name, a positional hierarchy we are comfortable with, and a voice. To remind everyone, there was more than one voice to listen to in that shameful broadcasted episode. The selection can also be found in how we have chosen to align ourselves using social media and remain without action at the same time. If we care about the consumer (and the families), how does social media become an effective component of an action-oriented campaign?

?It’s time we bring our outrage and adult this thing out…its time that we grow?beyond a social media post that marks our disguist. Instead, let’s be outraged together over the larger issue we have in our field.

What issue? Our clinical practices that “do” the devaluing daily in action and deed. Let me go on... It's challenging for me to look at this?topic only through the lensed discussion held by Kayla and a few of her colleagues. It's bigger than the #kaylaperry podcast discussion.

?Let’s take a look at how the words and the deeds of devaluing can be seen in our daily practices:

• The use of casual statements that value skill over a client's age
• Lowered expectations for our client’s achievement and decide who we label with 'functional' goals.
• Supervision turned to counseling (without a license) versus a referral for the clinician we mask concern over
• DEI conversations that are circular
• ?Organization sanctions ( by a major insurance company)?for writing terrible reports and all the licensed BCBAs who work there are outraged…and begin to slowly improve clinical skills and report writing. Meanwhile, everyone continues to come to work (daily) providing clinical services using those same poorly written reports to guide the clinical team.
• Clients graduating from services that are more reflective of program age maximums rather than clinical skill attainment.
• Friendship falsehoods between clients and therapists because we have created social goals that arrest clients social development and autonomy.
• Providing backroom laughter and sarcasm when parents share the dreams they have for their children.
• It is seen we discuss how cute our clients are to deflect from the data we didn't take.
• When we excuse data collection because everyone is learning and still bill for the treatment as it treatment occurred.
• When we the time and fiscal dollars of our families by calling it intervention
• It is seen when we award clinicians with promotions who are loyal to a company versus their knowledge?and clinical acumen.

?We have a value problem. An identity problem. And an attention problem.

Devaluing people in words and deeds are equally outrageous. The words spoken in the podcast by Kayla and her colleagues were horrible. Clinical work with little to no impact is equally horrible. Clinical work that takes for granted?the time of clients is also an act of devaluing. We should be equally outraged, not selectively so. ?

Assuaging ourselves through posts is something that makes us look good. It’s a narcissistic act that does not separate us (as much as we’d like) from the conversation Kayla had amongst her friends. Sure, the stance we take is a polar opposite one, but the “this is what I think” action is cyclical. Not impactful…not all all.

• Impact is economic.
• Impact is connecting and discussing solutions.
• Impact is action-oriented.

?

In order to turn the tide within our profession, we have to be bold enough to face what we need to face, have tough conversations, and sit people down who represent us haphazardly. But we cannot do this when our energy leans towards a like-me button and our attention shifts so rapidly. Sure, we count the cost and sometimes it's too great. ?

In the case of the podcast and participating at the conference, there were well-intended people who reached out, and some not so well-intended. Some postured that as a leader…I (we) should.... Dr. Nasiah and I land similarly here as well…the selective ask and implicit bias of it all. It’s audacious indeed to wonder why/how people would continue to speak at the conference. In thinking about selective outrage, it's interesting to selectively ask black women to sit this one out when we didn't ask our research professors to sit out ABAI (or name your conference) when all things happen(ed).?

It's selective. It’s the “I trust you to make these decisions until you need my unsolicited guidance”. I will also add here that there are some who are well-meaning and then there are those who ask with a hint of threat and abrasiveness. For the record, I am an adult.

?We can't be against censorship and censor. Because where and when would this end? Who would decide? We would have these campaigns of censorship and canceling people via DMs and emails. That’s not how a profession goes.

?Do I think the conference organizers have a responsibility to address this head-on? Yes

Do I think organizations have a?responsibility to consumers after listening to the podcast? Yes

But why selectively choose one person?

?In short, we have to ask ourselves (quietly) about our bias and our need to be received by the masses on social media.?We have to ask ourselves how we accept racist, misogynistic, over and undertones within our profession and choose THIS time to be outraged. What is it about this time that didn’t happen the last time? You don’t have to answer…just keep in mind that implicit bias is real. It’s shown up in your DMs, your queries asking why, and how we are for and against censorship at the same time.

?My dad would always tell us to NOT get mad, but get smart(er).

?Listen…do what you like …LIKE, AGREE, POST, CREATE on the interwebs. I also ask that we do more than that…otherwise, it's just another post.

??Be Well,

?Landria Seals Green?

#autism #behavioralhealth #communication #speaker #accountability #specialeducation #humandignity #leadership #clinician