Op-ed column: New treatment, decent pay could curb the abuse of autistic clients

Edwin Tirado was sentenced to 15 years in prison for his part in the February, 2007, death of Jonath
Michael Osbun/Tribune Media
Michael Osbun/Tribune Media

Edwin Tirado was sentenced to 15 years in prison for his part in the February, 2007, death of Jonathan Carey, an autistic boy who was under Tirado’s care at O.D. Heck. Now there are charges against four other O.D. Heck employees, one who punched a blind, autistic client and the other three who didn’t intervene when the incident occurred.

Autism is a brain development condition that impairs social interaction and communication, and causes restrictive and repetitive behavior that begins before the child is 3 years old. The manifestations of autism differ widely. There are high-functioning autistic people like Temple Grandin, a professor at Colorado State University who has written several books. And there are autistics who don’t speak and are occasionally violent.

How to best treat people who are affected by autism is hotly debated, but there is a certain kind of treatment that is getting great reports. Applied Behavior Analysis, or ABA, which involves individualized monitoring of behavioral cause and effect, has proven to be very helpful.

New York state will require special education teachers to have autism training, some of which may be ABA based, by 2009. In the meantime, the Office of Mental Retardation and Developmental Disabilities is undergoing an overhaul in the wake of Jonathan’s Law.

Problem for families

People are confined to places like O.D. Heck because families are not equipped to deal with them. In other days, people took care of such children at home. I had two cousins who were “different.” I don’t believe that either one was autistic, but each was a problem for all of their lives — one lived to be nearly 80.

Nowadays, children who are developmentally disabled or autistic are often placed in private or public facilities. Families are spread out, so extended family can’t help to care for children. Also, there are usually two breadwinners, and kids with special needs don’t fit handily into the day-care/school equation.

If your child were placid and nonviolent, he would be just what the caregivers at a “home” would like. The “client” would require just the basics of feeding, diapering, getting ready for bed, etc.

If the “client” is prone to violence, however, the caregiver will have to be ready for anything, and being constantly off-balance could make the caregiver nervous. Without proper training on how to handle a problem, physical control might seem the only solution.

Are workers given all the training and support they need to help them make the best choices when responding to outrageous and dangerous behavior? Given the relatively low pay scale of personal attendants, I doubt it.

The situation is hard for all involved. Sometimes I feel that difficult children are foisted off into group care. I don’t think any cruelty is justified, at O.D. Heck or elsewhere, but I can understand how workers might get frustrated and strike out at their charges.

Abuse common

Abuse is common in institutional settings. In prisons, inmates are subject to the whims of guards, but prisoners are violent to each other, too. I have often reflected, in my writings and in stories I tell my family, on a youth spent at the mercy of nuns and brothers at St. Agnes’ and Vincentian Institute. There were 70 kids in my kindergarten classroom, and about 50 children in each of my other grades. As we students grew old enough to purposely get on the teachers’ nerves, we did, and were treated in kind. I wonder if even the Shakers, pacifists though they were, might not have used the canes from their caning efforts to swat the seats of those who misbehaved.

So what is the answer to the particular problems repeating themselves at O.D. Heck? Hopefully, the changes that will take place over the next few years at OMRDD will foster a restoration of the word and deed of “service” to this social service arm.

However, internal oversight will not address the fact that aides and workers are literally not valuable assets. Once we can find the funds to remunerate such labors, people may be ready to really care for the clients they nominally care for.

K.C. Halloran lives in Melrose. The Gazette encourages readers to submit material on local issues for the Sunday Opinion section.

Categories: Opinion

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