Welcome to From the Spectrum Podcast. This is a podcast about autism. It is my
goal to explain what is autism. I plan to use a mixture of scientific literature,
personal experience, and opinion. With opinion, I will explain why. I feel the
way I do and give examples. I will provide links to various references for each episode.
For each episode, we will discuss various aspects of autism. For today's episode,
it is my pleasure, with overwhelming excitement, to announce the first guest of
the podcast. From UCLA, George Tarzan Distinguished Professor of Psychiatry and
Education, Dr. Catherine Lord. Dr. Lord is not just any guest. When I and most
others think about autism research, knowledge, and education, there's a
short list at the top. The top of the top tier. With numerous contributions, such as
the Autism Diagnostic Interview or the ADI, the Social Communication Questionnaire,
and the Autism Diagnostic Observation Schedule or ADOS. Two are considered the
gold standards in autism assessment. In addition to back my thoughts about Dr.
Lord's contributions to autism, a paper released in 2023 in Frontiers in
Psychiatry shows she is the most impact and productivity in autism from the
years 2011 to 2022. As you listen, please consider some potential highlights of our
conversation. Dr. Lord's journey into autism and notice despite the highest
impact score in autism research, she still takes referrals and sits in on IEP
meetings. The evolution of the autism assessment process and the evolution of
the ADOS from her basement and being overran by demand to the gold standard in
autism assessment. How centralized money, medicine, and education interacts with
autism and the language used in policy and politics and in the DSM. Remember my
previous comments about the DSM. Don't get hitched on this book. And finally, how
the word spectrum is interpreted in professional and in the public. An update
on profound autism and the future of autism.
And now my discussion with Dr. Catherine Lord. Dr. Lord, why don't you begin with
just telling us when did you know autism was going to be your focus? I think as
an undergraduate, I worked for LowVos doing very traditional behavioral things
and I worked with two kids who I just loved and I by the end of working with
him for a couple years I was pretty negative about simple behavioral
approaches. I felt like boy this is not the answer but I loved the kids and then
I went to graduate school and deliberately went away from behaviorism.
But in my last year of graduate school I ended up just by accident teaching a
class of kids. It was just after IDA so when special ed kids were schools were
required to let kids into school kids with disabilities and I taught a class
of kids coming to school for the first time who were between three and eight
years of age. This was in rural Vermont and in fact about half the kids had
autism. All kinds of things. I mean they ranged from you know a really smart
little girl who was blind who also had who had autism who could play the piano
like you never heard it and who used to shout at herself. Tammy stop playing
that goddamn piano which was very embarrassing but who you know to a child
who couldn't talk and everything in between and and I think then I just was
like oh my gosh I really like these kids I don't know why and and so then I went
when I was had to do an internship I also was trying to find a position where
there were people very committed to clinical work but who also did research
and it was really hard because I found great researchers who didn't care at all
about clinical work and then I also found really good clinicians but who are not
reading or doing any research and then I got the position in North Carolina at
Teach which at the time was I mean it wasn't brand new but it was just folding
out and that was an amazing experience so that just did it for me. So as you
described those children long ago it seems like correctly from wrong the
profession in society didn't really recognize it yet as this big continuum
or spectrum like you described it is that correct? That is absolutely true I
mean you know I think Lovaas took on autism because he was very interested in
behaviorism and he thought that with these techniques we can teach anybody
anything and then he'd heard of these kids who weren't communicating in an
ordinary fashion so he literally I mean what was amazing was he brought kids out
of a state hospital and they lived here on campus and the idea was we were going
to cure these kids which is ridiculous but and then I worked with two kids and
one little guy never did what I was trying to get him to talk he never talked
we were both dying of boredom so we spent a lot of time in the bathroom you
know I got him to you know wash his hands and we learned how to get paper towels
and we were really I mean about ready to throw spitballs I think and then the
other guy was a kid who I think had stopped talking when he was sent to the
institution once he came here and he had this army of predominantly young
women working with them he started talking and he was ahead of me every
step of the way you know I would be like all right we're gonna work on
pronouns and he would be saying you would be using pronouns you know so that
was very interesting too so I just felt like there's so much we don't
understand here that and I'm not completely negative about all behavioral
techniques but I think you know it it it was so oversimplified that we what we
were gonna do and what were what were we trying to accomplish yeah that's a
great that's a great mindset the idea of like the ABA or this behaviorism is
interesting to me whereas it's it's another human being instructing another
human being on on what they should be doing or ought to be doing but who's to
say that the the instructing human being you know it knows what's best for
that in this case a child yeah so that's the hard part you know and I think
with these two kids we were way off because one of them you know he couldn't
imitate sounds so for me to spend for us to spend 40 hours a week trying to get
him to say bah and the idea that he was gonna say bah in order to get a Frito
he the poor kid couldn't do it but he could do other things no and then the
other kid was ahead of me he was like I was you know he could have taught me the
sad thing is he went back to the institution and stopped talking again
and so we were just doing the I mean we were doing something right which was
giving him all this positive attention but the actual teaching of language was
neither here nor there and I do have very mixed feelings I mean I think
hopefully this I can say this well because I do think sometimes we have to
say like sometimes I have to say look I as an adult I do know more than you as a
three-year-old about what life is like and what you're gonna need to learn but
also I want to respect what you are good at and what you're interested in and
the more I can do that the more we're gonna learn together absolutely that's
and that's the trade-off and I think we've had you know real pushback from
the autistic community like let's not you know I I shouldn't be making any
decisions but sometimes I feel like you know I mean we have some patients who
are periodically physically aggressive and it just this is not good it just
harms them and it's such a shame you know because it restricts what they can do
and so I do think somebody then has to jump in and say alright how do we help
them do other things you know and and so you do need somebody jumping in on the
other hand I'm not trying to say like don't look at lines if you like lines
you can look at lines and if you can draw by you know that is wonderful so
let's build on your strength but I'm still I am gonna try to keep you or from
pulling your mother's hair or whatever you know yes this given a little bit of
different perspectives can go a long way yeah so before the creation of the
ADI and social communication questionnaire and the ADOS what was the
condition of the autism assessment like well I think I mean it's interesting
because one of the things that teach did in North Carolina was they were they
were one of the first groups to have like a standard assessment so they had
something called the PEP the psychoeducational profile and so the there
was a standard assessment but it wasn't it didn't meet like the standards for
testing that you know some of the famous tests like the SAT or the whisk or the
arm it didn't meet those standards but they were a group that really tried to
help figure out what do you do when you're face-to-face with the kid you
never met before and how do you figure out what they can do and one of the
concepts they had which we really used especially in the ADOS is this idea of if
you don't if you present a task to a kid and they don't seem to be able to do it
as you think they should what do you do next like how do you see if they can do
it if you change something you know if instead of putting out 20 blocks at once
you hand them one at a time you know is it just that there's too much stuff or
is it that the blocks are wooden and they don't like wood or you know those
kinds of things and so this idea of like a merging skill and being able to say
alright this is what this is how I needed to change in order to help this the
child that I'm working with be able to accomplish the task and then how can I
use that information in planning what we're going to do next okay yeah so as
you as you describe such details about the instruments from from a creator now
we all know that these these instruments get revised and modified
throughout but how do you know when they need revised or modifications oh goodness
they always need revisions I think the reality is they're always they are not
perfect so they always you know we always know we always have a list of like 10
or 20 things that we want to improve I mean I think at this point we are
partly captive to the fact that they're published by a business and so and I
think that's you know that is just a practicality you know for a long time we
literally made these things in my basement and then you know my husband was
like no plastic bags in the bathroom it was just crazy and we were getting hate
mail from plate people saying why can't you get get this to us you know we're a
little bit in that situation now because we tried to come up with a shorter
version and we're making kits but so I went to a company and they make it but
then what happens you know in terms of revisions is very dependent on them so I
think the revisions come both from us knowing this didn't work that well or
but also from changes in the field you know for example we're seeing many more
adults who haven't had a diagnosis before who are quite bright and that is
different than what we saw you know even 25 years ago when not I mean that we
definitely saw some autistic kids who are very smart but we also that it was
just a different group you know who is who is referred in preschool is different
than who is referred at school age and it's different from who's right so those
kinds of things say wait a minute we're gonna have to figure out better ways of
addressing this so always I would say you know but then the publisher like
there's gonna be a revised ADAS and we have been bugging the publisher for
years to do it and now they're finally ready so we are working away at a new
version but it's you know we do it and then it takes the publisher another
whole year to lay out all the forms and figure out what they're doing but you
should tell people that are listening we have lists you know if people have
complaints let us know we will file them away we can't do anything often
immediately but we we are listening and trying to figure out how to make the
thing better oh yeah I appreciate that I I read I read about how much input you
you you take on from like people in the community and people with autism so with
the current condition of the autism assessment what do you think the the
overall assessment needs what are the biggest gaps that's a really good
question I mean I think I think how you put information together is we have not
specified that we really have left it up to the clinician so you may have you
know these days you may have a parent who gives reports on the ADI which is this
long interview then you may see the person and do an ADOS which is just
scored the ADOS is scored from the time you start it to the time you finish it
like 45 minutes you don't score anything else you know so it's there's
because that you wanted to be reliable but then also you have information about
like what is what are the other things that are happening in people's lives
that for example a parent might know not me might not know so how do you put that
all together and I think we we don't tell people how to do that we really
leave it up to the clinician and I think that's that is both good because you
hope the clinicians are good working with whoever the person is who's come for
the diagnosis but it also means people don't know what to do if you're getting
you know if you have somebody who really feels like they have autism and you see
them on the ADOS and they don't look like they have autism what do you do you
know or you have a parent who is describing all kinds of things and you
don't see it what do you do and and so that that's a gap I think we also so
far the ADOS has worked the ADOS at least has worked quite well across different
cultures but it really is which includes sort of gender so but it really is up to
the clinician to modify things you know to say wait a minute I have in front of
me you know a young woman who is you know interested in princesses and not in
cars so I need to pull out this toy or whatever and and that's not as well
specified as it should be of how how can you be flexible within it so I think
that's another issue and it's I mean we are dealing with the practicalities of
a medical system particularly in the United States you know that's very
focused on procedures like what do you do in the office you know that's how
billing works and often you need other information and so how do you how do you
incorporate that information you know both from the person seeking the
diagnosis but also from from other people who might know them in other
circumstances okay yeah yeah and something that something that interests me
is especially now more and more is this idea of early screening even if it's by
like a PCP so I have a couple of questions on that is one is does this
screening is it as standardized as let's say an assessment or one of these
instruments like how do we know that the PCP is equipped and can handle this
screening and then this is yet does the screening help the overall process of
the assessment now we know that it would help the treatment plan the earlier
you get the treatment the better off the better the outcome but does that kind of
help the assessment at that younger age as well I mean I think the screenings
help get it get people to think about the possibility of autism you know at
this point most of the screening is either questionnaires for parents
filling out or very brief things that our people are experimenting with so in
terms of like showing a kid an iPad and seeing if they look at two children
playing together or they look at a tree you know but there isn't yet so there's
beginning evidence that those might provide you useful information but it's
very very new and I think you're right how people are going to use that
information is not clear I think if people use it like one source of
information you know it's just like one thing then then that's fine I mean it
gives them an idea of like wait a minute I need to stop and worry about this so
that's that's good it gets people thinking about autism but if people use
it in place of like actually spending time with the child and figuring out how
does the child go about doing things and what are they interested in and how can
you get them to do the things like talking that you want them to do I think
that would be really harmful so I think the screening if it's if it's just
getting people to think about stuff it's fine but if it's treated as an answer
it's not like we just got a referral of a child who has been screened numerous
times never got a diagnosis has a developmental delay category and he's in
a preschool program he's been there for a year and he has I think he's got autism
and nobody has really looked at this carefully it's like what are you thinking
you know so that I feel like it's not an end it's a beginning you know and I
think it's you know if you think about like going to a doctor and they do like
a blood panel you know mostly they don't stop that that's a start it's not a
be it's not an end you know unless they say ah ha you have strep throat I'm
putting you on this most of the time it's just a beginning and that that's
where it's important yeah yeah okay so this idea of as you describe that that
child in preschool going through those numerous screenings it's like this idea
of spectrum as we kind of lump everybody with autism into this white
spectrum I'm kind of concerned that for a couple of different reasons maybe the
biggest one is how wide or how much of a variety there is let's say from like a
level one high functioning to a level three that has completely different
looks to it and my concern is how how do people from the outside looking in how
do they know like how do we teach society about this broad spectrum yeah I
I mean I agree I don't know I think part of the problem I mean the reason why we
would start with autism and not just say alright it's actually three different
things or two different things I think there's two reasons one is that at
early ages you can't tell we can tell that a two-year-old or three-year-old
has autism we can't predict at especially at two we can't predict are they
going to be even if that you know are they going to be brilliant with autism
and you know getting a PhD in physics or are they going to be nonverbal so we
we can't tell and we can begin to tell it's gradual at like three and four and
five but we can't tell with the tiny kids and we want to get them in services I
mean one of the things our Lancet Commission really tried to say is kids
should be able to get services before they even get a full diagnosis you know
if you're worried about the kid get them in and then say alright sometime this
year we got to do a better assessment so we know him better so he's not like the
little guy just described but let's not wait but we don't know so that's one
reason why we need sort of autism spectrum the other reason is there's a
ton of people in the middle between the physicist and the person who can't talk
and what do we do with them I mean we've been working at trying to have a
better definition of profound autism of like people that are really very
handicapped and we can do that but then what what about everybody else and
there's such there's still a spectrum from people that are really totally
independent and just have some struggles with some of the social things or some of
the sensory things that affect people with autism and then there's people who
are really you know very their lives is very different are very different because
of the autism you know even though they're bright and they have other you
know they have many strings so where do we put them and I don't know and the
trouble is they're not those people are mostly not making podcasts they're you
know they're there and we see them in the clinic but they're not and for now
actually most many of them are not getting help at all and so what do we do
about them so I don't know but I do I do I don't feel like I have the answer at
all you know and I get why you know a few years ago we thought oh it'll be
genetics everyone will know what their genetic disorder is and they won't need
autism but the reality is the genetics even when you know what the genetics are
you know one-third of the people might have autism and one-third of the people
have epilepsy and one-third of the people you know there's there's enough
there is no single genetic a cause of autism only you know and then most people
with autism don't have these so I don't know I'm ready to listen to you Ryan
and what what we should do that would be more helpful and it's so confusing to
families I think you know I feel like into the public because the public
thinks everybody you know people with autism are like the good doctor which
is just not true but there are people who do really well yeah so I don't know I
I don't know it's it's easier for society looking in to recognize like the
good doctor and then recognize the profound yeah autism but there's so much
in between yeah and the the genetic not one thing and not even if you have that
genetic dysfunction I guess if you will it doesn't necessarily mean autism yep
well there's a whole patchwork of things going on way upstream in our
biology that is just hard to hard to capture this idea of the spectrum though
is like you know I get concerned about how people view it and not having
distinct edges I heard dr. Vinster Vanderwill I believe talk about not having
edges so we can you know better have more understanding of like this group of
people with autism and this group of people with autism but there's just so
much yeah I'm hoping that since you mentioned and we touched on profound
autism and the Lancet Commission I'm hoping that you can give an update that
was released in 2022 I believe and just seeing how that goes or how that's going
yeah I don't know I think you know I mean one of the things I want to say
about the Lancet Commission is profound autism was just a tiny part of it but
it's gotten more attention than anything else and the major thing that the
Lancet Commission was trying to say is we need more research on what actually
makes a difference in people's lives and that we do need to work with the
autistic community you know both people with autism and also parents to figure
out what makes a difference because we know we know so much more about
biology which is very interesting but is on the whole has not helped and so it
will help I think someday but it's very long term and and we need to know more
just like how many hours of something does a kid need and how do you decide and
and you know does telehealth CBT work you know for whom and why not or why and
those kind of things so that was the main point and then also across cultures
because you know most of the research has really come from Europe or the US or
to some extent some of the wealthier Asian company countries but there's a
lot of autistic people out there who don't get anything so that I'll just put
in my push for it because profound autism just hit the news more I think
that you know there's now to you know there's now the profound autism alliance
and there's you know I think both you know that the major research
organizations are recognizing profound autism there was a lot of conflict over
what would go into you know they're they're trying to pass a new bill for
autism cares in Congress and there were really very different groups who are
saying you know if you mentioned profound autism we won't sign it and then
other people saying you have to mention it or we won't sign it I think they've
agreed on words you know you know and but I'm not sure even what those words
are but I think the idea of like high support needs so I think that's a big
step and at least recognizing you know it's just ironic because most of the
biological research on autism that at least the genetics has been on kids who
are very handicapped and then all the other research is mostly on people who
are not and so there's just again this middle that doesn't get addressed and
then there's also the we need behavioral research on people that have more
severe issues and we need well I don't know how much we need the genetics of
brighter people I'm not I'm more skeptical that's I'm skeptical that's
going to help a whole lot but anyway it's just I think people are getting more
used to profound autism and the idea but it but there's various groups you know
they're groups that want us to declare who has profound autism when they're
three years old which I think is really wrong because you don't know no on the
other hand I think accepting the fact that there is this broad spectrum and
sometimes people who can't speak for themselves are left out and that we do
need families and we need to recognize that someone needs to advocate for these
people because they're they're not able to talk to you know write books or or
speak or they can speak but they they can't really stick up for themselves
and what they need yeah I I just read a paper and I think it just came out about
this University or research center claim that they could predict profound
autism versus non-profound autism based off of the size of a brain or
something in the cell biology if I'm not mistaken I thought that was kind of
interesting I don't know I mean they might I mean I do think there's certain
genetic disorders that are very much tied to intellectual disability and
often seizures and so the chances if you have those of having if you have
autism which not everybody does of also having intellectual disability are
high but I would hate for people to be limiting kids when they're very little
you know saying they're never going to be able to do this or that you know I
think I mean what we're interested in you know just because we've been doing
research so long is the trajectory like what is the how are you changing and if
you can use that plus what who is helping and who is not then I think that's
much more useful it's just that it's you know from a medical point of view it's
more time-consuming if you have to have two or three points instead of just one
yeah I want to highlight a couple of things after that one I don't remember
if it was in nature reviews disease primers or that Lancet Commission I
believe it was the Lancet Commission that it's mentioned that it's easier to
get approval for like medical specialists than it is these slower level
like treatment plan options which is a concern yep that's I remember having a
meeting at one of the finance companies in New York I forget which one but like
sound like Chase or JP Morgan or and the physician in charge said yeah we'll pay
you know any kind of medical specialist you know but you know but we won't pay
like a education person you know to work with a child and they're like because
we think we have the cream of the crop you know reimbursement but it's like at
some point somebody needs to sit down with the kid and work with them you know
so you could have an you know 20 medical specialists but nobody's going to help
toilet train that child or you know help him learn to say you know cup so I
think that's again that's part of our crazy system in terms of medicine and
it's just I mean it they've worked it out like I mean just as a person getting
older I've had many more medical procedures in the last few years than
ever before and you realize that there are tech you know technicians you know if
you go to have some kind of cardiology exam you know somebody prepares you
there's a nurse there's all these different levels before you actually see
the physician but they're preparing you for whatever the physician is going to
do whereas I think in autism we just need people who are going to work you
know work with people and that's that doesn't have to doesn't require a PhD
or a SID or an MD but it does require thought and kindness and planning and
experience so I don't know that that idea of those people on the front lines if
you will those so-called lower level people they're they're the ones that's
going to have the most impact I think in the best outcome yep and that's I guess
one of my concerns is with that diverse knowledge and information or whatever
about this idea of this wide spectrum does that interfere with some of the
research and financial backing and people that make decisions does that
interfere with their recognition so I mean I don't know yeah I don't either I
mean I do think that even like the levels you know I mean the levels in DSM 5
are there because we were told as a committee we have to have levels and
the whole committee was up worried about them so they're really written almost
circularly because we were really worried that there would be people that
wouldn't get services because they were the wrong level or that people insurance
companies wouldn't continue to use services if people aren't moving up
levels and so they don't make any sense you know and we knew that I mean but
it's how do you you know I mean you need to have ways of measuring if
somebody's making progress starting where they are but that is more work than
it doesn't fit with our medical system on the whole you know and the idea that
you go in and have blood tests and somebody says aha you have that viral
infection or you know which is just not autism it's not a viral infection and
I'm reminded a little bit about so those barriers in the medical medicine and
then also in education that the knowledge and information about how someone
with autism learns and the current classroom situation has to my
understanding that I've figured is like four strikes against autism the social
communication dynamic the sensory processing dynamic the speech and
language dynamic and then this task switching or the subject switching which
is very much against B3 you know you 40 to 50 minutes on the subject can you
change subjects 40 to 50 minutes and if you have B3 you hate that that is very
challenging yeah so I mean I think there there's another you know hard choice
because on the one hand I think having you know very segregated classes that
never interacted anybody except the most autistic kids is not great but I also
think I mean school can be torture you know I mean I still I mean I do not I
don't have autism but I just think how did I spend eight hours a day sitting
with 34 other people all day long doing what someone else told me to do and I
don't have the the sensory issues or the social I mean I'm not that social but I
think that you know it's it how and what do you come up with as an alternative and
I think it's relevant also not just to autism but even with kids with ADHD for
example different issues but you know so being in a big class without a lot of
flexibility and then changing classes as you said I mean I recently was on a IEP
meeting for a school for a kid I've known forever and he is going into high
school and I was so impressed because he has he is autistic very smart but
autistic and he the they were going to put him in a class that was taught by two
teachers and different class every single class was taught by two different
teachers so he was going to have seven classes each with two teachers and the
I think it was like the school psychologist and we were just like oh
this is going to be awful you know and the schools like college has just said you
know why don't we not do this like it would be better for him just to have
somebody who's responsible for getting him you know I mean he really does not
need an aide following him around all the time but somebody who's responsible
for him all the time and then let him do what the other kids are doing and then
we're going to have him have fewer classes not because he's not smart enough
because it's just too many changes yeah and trying to help his family and him
realize maybe it's going to take you if you want you know an honors high school
diploma it might take you an extra year but you do not have to have seven
classes you know that is not set in stone for the rest of your life let's
just get you through this and maybe he can have two art classes because he's a
wonderful artist and it's not that we're giving up on everything else it's just
let's pace it but it's very hard you know the idea of two teachers and seven
classes 14 teachers you know you're right and I mean we've been having him
like leave class early so he's not in the hallway noisy go to class I mean it's
just anyway it's a concern for me and for my experience as well as
if you have autism and you're navigating society over years of doing this all of
that expectation and that just plasticity of how you're shaped and
developed is very opposing it's it's many challenges yeah it is it it absolutely
is and it's it it shouldn't have to be but it is yeah and for education it's
hard to change because they have to teach the general population first right
and then you know these so-called outliers yeah yeah it's tough I'm
anxious to see how that evolves which which brings me to another question what
does autism look like in 10 years in your opinion oh good question good question
um actually that's I don't know I mean I hope that there's less conflict between
you know the autistic advocacy community and other people so I feel like I feel
like the you know autism's advocates have really important things to say but
sometimes it gets overwhelmingly negative at least for me as a practitioner
and I feel I hope that gets resolved I hope we can work out ways of communicating
that aren't offensive to people and move toward strategies that that you know
people aren't so you know so negative about so I hope that improves because I
think that's a hard thing right now for many practitioners and you have people
who just jump into it full force but it's just as someone who often sees
smaller kids and and I do think things like behaving yourself reasonably are
really important to allow them access to things they want to do and somebody has
to help the kids figure that out but so that's something I hope gets better you
know I think that we need to know more for research I feel like we you know
genetics is going to continue on with a ton of money and but I think the reality
is that the the miracles that are going to come for genetics are not going to
affect your average autistic person they're going to affect someone with
some very rare disorder that someone happens to figure out you can give them
a shot when they're born or whatever and that's not going to affect probably
anybody that I see or you see you know I mean that will be great if it's true so
I think we need we need to understand more the relationship between how does
the brain actually work not just in autistic people but anybody and and then
what can we what does that mean for what we do because we're human beings we're
like not little brains walking around we're whole people so I hope that people
move in that direction and then I hope that there's I mean I think early
intervention is really important but I think that we need to recognize that
that early intervention isn't an answer in itself I mean you want to get kids
started and you want to move forward and particularly in language we need to see
changes early on or they're going to be very slow but I think we want to also
recognize what happens for school-age kids and what can we do better and what
happens in teenage years and adults and I hope that there will be better services
and more knowledge about what what we could do to make life easier or better
for people and better services for adults yeah yeah well said that concern is like
the trend of I guess it's now one in 36 children it's like when does that balance
or when does that stop trending that way yeah I don't know it's very concerning
okay so so last question now I'll let you go dr. Lord if you had a magic wand
what would you like to know about autism if you could have one question
answered oh goodness
um
I don't know I don't think there's one yeah I think it's probably different for
different people you know
I guess I would like to know better how do we find the strengths in an
individual child or adult that wouldn't that will most help that person have a
happy life and how do we do that and I don't think there's gonna be one answer
but I I feel like we're grappling with that all the time but I I don't I don't
know you know I mean we just look at what we can do and make guesses those
those strengths are in there too somewhere they are they absolutely are they
are I'm satisfied and pleased that you said that gives them a happy life leads
them to a happy life yeah it's it's I mean people can be people I mean I guess
it's true for anybody can be happy and people can be not happy but how do you
do that how do you support that and and I think I'll think we'll get better at it
but I don't know the answer if you figure it out Ryan let me know how I
would love to I would love to let you know that would be my pleasure well
well dr. Lord I can't thank you enough for your time I know you're very busy
impacting the world and the field of autism and I very much appreciate that
I've I followed your work and I'm I just love reading your material so thank you
and just thank you so much my pleasure it's very nice to meet you Ryan and I
wish you luck with the podcast and your own studies yeah all right bye bye
thank you for listening to the conversation with dr. Catherine Lord if
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