Dear Health Minister Clement: Re Autism Gold Standard Intervention

October 31, 2007

Honourable Tony Clement
Minister of Health (Canada)

Dear Honourable Minister

Recently your government filed its response to the Senate's "Pay Now Or Pay Later" report on autism services and funding in Canada. As the parent of a profoundly autistic 11 1/2 year old boy I have been active in autism advocacy in my province for the past 9 years. I was disappointed, extremely disappointed, with your government's weak response to an issue which now is estimated to directly affect 1 in 150 Canadians and their families.

In particular I found objectionable your government's stated position that there is no consensus on a gold standard of treatment for autism. That position is simply inconsistent with the professional literature as I understand it, admittedly from the perspective of a mere parent. State and federal agencies in the United States over the past decade from Maine to New York to California have routinely described ABA, Applied Behavior Analysis, as an evidence based effective intervention for autistic children; the only intervention to be accorded that level of recognition of its efficacy.

This week the American Academy of Pediatrics released two autism reports one dealing with, and setting out recommendations concerning the need for very early diagnosis of autism disorders in children. The other report included a review of the professional literature on autism interventions. In Management of Children With Autism Spectrum Disorders the AAP stated with respect to Applied Behavior Analysis (ABA) :

The effectiveness of ABA-based intervention in ASDs has been well documented through 5 decades of research by using single-subject methodology21,25,27,28 and in controlled studies of comprehensive early intensive behavioral intervention programs in university and community settings.29–40 Children who receive early intensive behavioral treatment have been shown to make substantial, sustained gains in IQ, language, academic performance, and adaptive behavior as well as some measures of social behavior, and their outcomes have been significantly better than those of children in control groups.31–4

With all respect Honourable Minister, the position that there is no Gold Standard treatment or intervention for autism, is not in the language of the legal profession of which I am a member, "credible". I ask you to reconsider this stand by your government. I also ask you to look past the strict interpretation of Canadian constitutional jurisdiction over health matters on which your government and Mr. Duceppe's Bloc Quebecois relies in opposing federally funded ABA treatment for autism. Cooperative federalism has worked well in many instances in this country and to my knowledge is not inconsistent with the ultimate separatist aims of Mr. Duceppe's party. Before his party achieves full sovereignty autistic children will be growing older and needing ABA services in Quebec where autistic children despite claims of "we do it differently" are also badly in need of funded ABA services.

I ask you to put aside petty politics and help autistic children wherever they reside in Canada. Put the ideology and rhetoric in a drawer for safe keeping and help autistic children with some of the multi billion dollar federal surplus. Help autistic children now. Tomorrow is too late.

Harold L Doherty
Fredericton NB

Politics Blocs Help for Autism - Quebec

The motion by Charlottetown Liberal MP Shawn Murphy which would have amended the Canada Health Act to ensure funding for ABA treatment for autism was defeated by an alliance between the Harper Conservatives and the Bloc Quebecois. Mr. Harper and his Autism Front Man, Edmonton area MP Mike Lake, a father of an autistic child, argued that such an amendment would have constituted an intrusion into provincial jurisdiction. The Bloc in order to justify its existence in a federal parliament must be seen as fighting federalist intrusions into any aspect of Quebec life. But what did it cost Quebec children with autism for Quebec's purported separatists to grandstand and obstruct in the name of political ideology? Are Quebec children with autism different than children with autism outside Quebec? Is the Quebec government so wealthy that all autistic children are fully funded for effective ABA treatment?

The answer to both of these questions is "No" as the following excerpt from the CASLPA Canadian Association of Speech Language Pathologists and Audiologists presentation to the Canadian Senate makes clear:

Quebec

The standard of care for ASD in Quebec is Applied Behaviour Analysis (ABA), but given that ABA is an intensive, one-on-one program involving roughly 20 hours of therapy a week, the province does not have sufficient resources to provide every autistic child with ABA when the treatment is needed.

In Quebec, the waiting list for ABA can be anywhere from six months to a year after diagnosis. This is challenging for hospital staff as speech-language pathologists are there to assist with the diagnosis but there is not any on-going mandate to provide treatment. Frustration with ABA waiting lists has caused speech-language pathologists and psychiatrists to seek out more cost-effective therapeutic alternatives, such as intervention programs that are designed to help parents support language development in their autistic children.

http://www.caslpa.ca/PDF/SenateCommittee_bried_nov2006.pdf

Unfortunately for Quebec's autistic children politics Bloc'd a serious effort to provide funding for the effective ABA treatment their parents seek on their behalf.

Harper & Duceppe Defend Canada, Quebec Against Autistic Children

Above are pictures of Stephen Harper, who stood up for Canada yesterday, and Gilles Duceppe, who defended the Nation of Quebec yesterday, against the threat posed by autistic children in need of treatment by ordering their troops to vote down MP Shawn Murphy's private member's motion calling for a National Autism Strategy. The motion sought amendment of the Canada Health Act to ensure that autistic children in Canada, no matter where they resided, would received funding for treatment. Congratulations to these two brave and compassionate leaders for fending off this horrendous challenge to the integrity of their respective nations.