Submission 39 — Dr Bruce Baer Arnold — Select Committee on Autism | External submission

Senate Select Committee on Autism

Department of the Senate

PO Box 6100

Parliament House

Canberra ACT 2600 12 May 2020

Submission: Select Committee on Autism

This submission responds to the Select Committee’s invitation to comment on the services, support and life outcomes for autistic people in Australia and the associated need for a National Autism Strategy.

The submission is particularly concerned with the development of a National Autism Strategy; the social inclusion and participation of autistic people within the economy and community; and the capacity and sustainability of advocacy, self-advocacy and self-determination supports for autistic people, including mechanisms to self-represent to government as enshrined in the United Nations Convention on the Rights of Persons with Disabilities.

Summary

What is typically characterised as autism is a manifestation of neurodiversity (aka cognitive diversity), in essence different ways of communicating and relating to people. ‘Autism’ has traditionally been used as a label for range of attributes on a spectrum, attributes that are medicalised as deficits in thinking/action that require a cure and justify discrimination in employment or provision of services. That conceptualisation may be administratively convenient but disregards the strengths of many people who are characterised as autistic. It objectifies people with the autism label, disregarding their individual experience and capability. That labelling is at odds with national productivity. Just as importantly, it is at odds with the flourishing of the autistic community, which encompasses both individuals who identify as having traits on an autism spectrum and their families.

There is no reason to believe that the spectrum is caused or exacerbated by vaccination or fluoridation.

The submission suggests that we look beyond overseas models such as the United Kingdom’s Autism Act 2009 and associated Autism Strategy, instead developing a national neurodiversity strategy that encompasses –

action by the Commonwealth government as a best-practice employer for the ‘information age’, building on recognition through COVID-19 that changes to traditional work practices are feasible;
community awareness in education, health and other fora regarding diversity and discrimination;
enhanced resourcing for childcare and early education; and
strengthening of Australia’s human rights regime through both statute law reform (including a justiciable constitutionally-enshrined Bill of Rights) and resourcing of agencies such as the Australian Human Rights Commission.

That strategy differs from embrace of the United Nations Convention on the Rights of Persons with Disabilities or the United Nations Convention on the Rights of the Child. It also differs

from prioritising genomic or other medical research at the expense of substantive support for families.

Basis

The submission  reflects doctoral and other research regarding  capability,  rights and

neurodiversity, for example the landmark 2010 Melbourne University Law Review article ‘It

Just Doesn’t ADD Up: ADHD/ADD, the Workplace and Discrimination’ with Patricia Easteal

AM, Simon Easteal and Simon Rice OAM. It also reflects research on Australian guardianship and disability law and practice, reflected in for example citation by the Australian Law Reform Commission in its Equality, Capacity and Disability in Commonwealth Laws report.

I teach law at the University of Canberra and direct the graduate law program at that institution. My work has appeared in a range of legal and medical journals, with a particular emphasis on genomics. The submission offers a legal rather than medical perspective on issues raised by the Select Committee’s Terms of Reference and does not purport to speak for the autism community or people who identify as being on an autism spectrum.

The submission does not represent what would be reasonably construed as a substantive conflict of interest.

Dr Bruce Baer Arnold

Canberra Law School

University of Canberra

Submission: Select Committee on Autism

Introduction Autism (often expressed as Autism Spectrum Disorder, otherwise ASD) is a new label for a spectrum of lifelong cognitive and/or relational attributes that are discernible throughout history.1 Those attributes are independent of upbringing. They are manifestations of difference but not necessarily of disability, in particular a disability that precludes full participation in community life and the workforce.

The label in retrospect has been used – often contentiously, often implausibly – to characterise

figures such as Albert Einstein, Kurt Gödel, Blaise Pascal, Emanuel Kant, Emily Dickinson,

Ludwig Wittgenstein, Edward VIII, Glenn Gould, Michelangelo Buonarroti, Alan Turing,

Leonardo da Vinci, Abraham Lincoln and Bill Gates alongside fictional characters such as Sherlock Holmes. Historically the label has also been used to stigmatise people who in law or medicine were categorised as mad, incorrigible criminals or imbeciles and thus incarcerated or denied respect.2

There is no reason to believe that the spectrum is caused by vaccination, fluoridation or what was once damned as ‘refrigerator mothering’. In particular, claims by ‘anti-vax’ advocates have been systematically debunked3 and are legitimately restricted in the public interest under Australian health law.4 The anti-vaccination movement lacks credibility, has relied on egregious fraud by high-profile figures such as Andrew Wakefield5 and causes substantive harm to public health by fostering infections that disproportionately harm vulnerable people such as those with immunodeficiency.6

1 The looseness of the characterisation reflects ongoing changes in diagnostic tools such as the International Classification of Diseases (ICD) and Diagnostic & Statistical Manual of Mental Disorders (DSM), where there is significant difference between editions, and the willingness of biographers or other authors to use new language to characterise expressions of neurodiversity. Among other discussions see Jeneva L Ohan, Sarah Ellefson and Patrick W Corrigan, ‘Brief report: The impact of changing from DSM-IV ‘Asperger’s’ to DSM-5 ‘autistic spectrum disorder’ diagnostic labels on stigma and treatment attitudes’ (2015) 45(10) Journal of Autism and Developmental Disorders 3384; Katrina

Williams, Marshall Tuck, Megan Helmer, Lawrence Bartak, Craig Mellis, Jennifer K Peat and Autism

Spectrum Disorder Steering Group, ‘Diagnostic labelling of autism spectrum disorders in NSW’ (2008) 44(3) Journal of Paediatrics and Child Health 108; and Donna M Kite, Judith Gullifer and Graham A Tyson, ‘Views on the diagnostic labels of autism and Asperger’s disorder and the proposed changes in the DSM’ (2013) 43(7) Journal of Autism and Developmental Disorders 1692. 2 Vikram K. Jaswal, ‘Rethinking Autism’s Past, Present, and Future’ (2017) 130(2) American Journal of Psychology 243. 3 See for example Anders Hviid, Jørgen Vinsløv Hansen, Morten Frisch and Mads Melbye, ‘Measles, mumps, rubella vaccination and autism: a nationwide cohort study’ (2019) 170(8) Annals of internal medicine 513; and Gabrielle M Bryden, Matthew Browne, Matthew Rockloff and Carolyn Unsworth, ‘Anti-vaccination and pro-CAM attitudes both reflect magical beliefs about health’ (2018) 36(9) Vaccine 1227. 4 That harm is sufficient to justify intervention such as Australian Vaccination Network Inc v Health

Care Complaints Commission [2012] NSWSC 110; Australian Vaccination Network Inc v Department

of Finance & Services [2013] NSWADT 266; Kingsford & Kingsford [2012] FamCA 889; Dr Floreani v Chiropractic Board of Australia (Review and Regulation) [2017] VCAT 2077; A New Tax System (Family Assistance) Act 1999 (Cth) s 6; and Public Health & Wellbeing Act 2008 (Vic) s 143B. 5 Among many studies of the Andrew Wakefield fraud see Cassandra A Richards, ‘Wakefield study linking MMR vaccine, autism uncovered as fraud’ (2011) 24(2) Infectious Diseases in Children 1; Dennis K Flaherty, ‘The vaccine-autism connection: a public health crisis caused by unethical medical practices

and fraudulent  science’ (2011) 45(10) Annals  of Pharmacotherapy 1302; and Fiona Godlee,

‘Institutional and editorial misconduct in the MMR scare’ (2011) 342 British Medical Journal d378.

6 Susanna Esposito, Paolo Durando, Samantha Bosis, Filippo Ansaldi, Claudia Tagliabue, Giancarlo

Icardi, and ESCMID Vaccine Study Group, ‘Vaccine-preventable diseases: from paediatric to adult

There is disagreement about the prevalence of the spectrum among the Australian population, including diagnosis of young people. Substantial changes to diagnostic tools and reporting, alongside reduction of stigma,7 mean that the spectrum is gaining greater identification but the number of people on the spectrum is not increasing. (As noted above, there is no reason to believe that there is an ‘autism epidemic’ attributable to vaccination.)8 In essence we are finding what we look for when we engage in labelling, as distinct from a significant increase due to environmental factors.9

The spectrum may manifest in isolation or instead be associated with other states such as schizophrenia, attention deficit hyperactivity disorder or psychopathy. As a caution about labels and abilities, psychopathy is often apparent among corporate executives and senior politicians;10 medicine for many years regarded people labelled as homosexual as manifesting a disorder that could be cured rather than merely punished. In considering any national strategy it is important to recognise that labelling potentially stigmatises, excludes and incapacitates rather than assists.

One diagnostic criterion for the spectrum is a persistent weakness in social communication

and  social  interaction, including  failure to  initiate  social  interactions,  difficulty with

conventional ‘back-and-forth conversation’, poor verbal and nonverbal communication, difficulty with ‘emotional relatedness’ (empathy) and thus developing and understanding relationships. Other diagnostic criteria include ‘repetitive patterns of behaviour, interests or activities’ such as rocking or other repetitive movements or ‘tightly focussed attention’.

Diversity in social and behavioural expression is not synonymous with an intellectual disability, in other words difficulties regarding learning, problem solving and decision making. People identified as on the spectrum may thus have exceptional analytical and/or creative attributes alongside a focus that is socially/administratively inconvenient or an inability to ‘read’ a personal interaction.

targets’ (2014) 25(3) European journal of internal medicine 203; and Stephan Guttinger, ‘The anti vaccination debate and the microbiome’ (2019) 20(3) EMBO Reports e47709. 7 Roy Richard Grinker, ‘Autism, “stigma”, disability: a shifting historical terrain’ (2020) 61(s21) Current Anthropology s55; and Bryna Siegel, The Politics of Autism (Oxford University Press, 2018). 8 Jon Baio, Lisa Wiggins, Deborah L Christensen, et al, ‘Among Children Aged 8 Years — Autism and

Developmental  Disabilities Monitoring Network,  11  Sites, United  States,  2014’ (2018)  67(6)

Surveillance Summaries 1; William D Graf, Geoffrey Miller, Leon G Epstein, Isabelle Rapin, ‘The autism

“epidemic”: Ethical, legal, and social issues in a developmental spectrum disorder’ (2017) 88(14) Neurology 1371; and Morton Ann Gernsbacher, Michelle Dawson and H Hill Goldsmith, ‘Three Reasons Not to Believe in an Autism Epidemic’ (2005) 14(2) Current Directions in Psychological Science 55. 9 Sula Wolff, ‘The history of autism’ (2004) 13(4) European Child & Adolescent Psychiatry 201; Bonnie Evans, ‘How autism became autism: The radical transformation of a central concept of child development in Britain’ (2013) 26(3) History of the Human Sciences 3; and Michelle O’Reilly, Jessica Nina Lester and Nikki Kiyimba, ‘Autism in the Twentieth Century: An Evolution of a Controversial Condition’ in Steven Taylor and Alice Brumby (eds) Healthy Minds in the Twentieth Century (Palgrave Macmillan, 2020) 137. 10 See for example Clive Boddy, Corporate Psychopaths: Organisational Destroyers (Palgrave Macmillan, 2011) and ‘Organisational psychopaths: a ten year update’ (2015) 53(10) Management Decision 2407; and Paul Babiak, Craig Neumann and Robert D Hare, ‘Corporate psychopathy: talking the walk’ (2010) 28(2) Behavioral Sciences & the Law 174. Note however Carlo Caponecchia, Andrew YZ Sun, and Anne Wyatt, ‘‘Psychopaths’ at work? Implications of lay persons’ use of labels and behavioural criteria for psychopathy’ (2012) 107(4) Journal of Business Ethics 399.

Presence on the spectrum is also not synonymous with a propensity to self-harm/harm, injury to others or other criminal activity. Australian courts properly do not regard the label as precluding criminal responsibility.11

We can productively address public policy challenges regarding people on the spectrum by choosing not to objectify those people, in other words not be determinative on the basis of a label. That choice reflects –

the instability of diagnostic tools,
questions about subjectivity in their use,
weak recognition that autism is a broad label for a spectrum of attributes (rather than a tight ‘one size fits all’ definition that is determinative of medical or other care),
variation in the life history and circumstances of people on the spectrum,
the impact of other conditions, and
the impact of stigma. We should recognise and respect what has variously been characterised as neurodiversity or cognitive diversity, a matter of respecting difference rather than necessarily a matter of disability or deviance.12

Difference is not deficit Australian law has been a matter of a slow and episodic advance towards recognition of the dignity of all people, a recognition that fosters the flourishing of both individuals and the wider community.

That advance has acknowledged the diversity of Australians in terms of different religious, ethnic, political or other affiliations. It has sought to erase discrimination founded on gender, marital status or sexuality. It has increasingly grappled with questions about rights and responsibility in relation to age, for example

the Gillick Competence of minors (the capability of young people regarding life- shaping decisions)13 and
discrimination against seniors. The latter is something of importance in an increasingly casualised workforce where being ‘over 50’ is often a recipe for economic exclusion and social immiseration and where being ‘over 60’ appears to be perceived by some employers as an opportunity to shed staff in response to COVID 19.14

11 There is a useful discussion in Ian Freckelton and David List, ‘Asperger’s Disorder, Criminal Responsibility and Criminal Culpability’ (2009) 16(1) Psychiatry, Psychology and Law 16. 12 Steven K Kapp, Kristen Gillespie-Lynch, Lauren E Sherman, and Ted Hutman, ‘Deficit, difference, or both? Autism and neurodiversity’ (2013) 49(1) Developmental Psychology 59; Andrew Fenton and Tim Krahn, ‘Autism, Neurodiversity, and Equality Beyond the “Normal”’ (2007) 2(2) Journal of Ethics in

Mental Health 1; Pier Jaarsma and Stellan Welin, ‘Autism as a Natural Human Variation: Reflections

on the Claims of the Neurodiversity Movement’ (2012) 20(1) Health Care Analysis 20; and Steve Silberman, Neurotribes: the Legacy of autism and the future of neurodiversity (Avery, 2015). See more broadly Bruce Baer Arnold, Patricia Easteal, Simon Easteal and Simon Rice, ‘It just doesn’t ADD up: ADHD/ADD, the workplace and discrimination’ (2010) 34(2) Melbourne University Law Review 359. 13 Secretary, Department of Health and Community Services v JWB and SMB (Marion’s Case) (1992) 175 CLR 218.

14 Australian Law Reform Commission, Access All Ages – Older Workers and Commonwealth Laws

(ALRC Report 120) (2013).

It is now time to both recognise and respect neurodiversity, acknowledging that people with autism are first and foremost people rather than manifestations of a deficit, in particular a deficit that should be ‘cured’ and that justifies discrimination in employment or other spheres.

It is also time to recognise that autism is a broad label, as noted above. Consistent with the preceding comment it is important to recognise that labelling may be administratively convenient but in objectifying everyone identified as ‘autistic’ or ‘with autism’ grossly disregards the manifestation and severity of a range of attributes at any one time or over an individual’s life.

In law we thus recognise that to be a woman is not to be defective, deficient or otherwise needing to be cured, although mechanisms to offset socially-entrenched disadvantage are appropriate for fostering the flourishing of individuals and the community. Contrary to anxieties based on ignorance and fear the past fifty years have clearly demonstrated the fundamental benefits for society, individuals and the Australian economy by removing legal disabilities that restricted women and by embracing positive measures that offset systemic disadvantage.

We should similarly be wary about objectifying people on an autism spectrum as necessarily disabled and ‘undeserving’ of mechanisms to offset disadvantage.

Some mechanisms are identified below.

The Commonwealth as employer The Commonwealth government has often provided a benchmark for state/territory

administrations and the private sector by aspiring to act as a ‘best practice employer’. That has

involved action  to  identify and address  policies and  practices  that were improperly

discriminatory, for example the historic expectation that women cease employment in Commonwealth agencies on marriage. It has reflected anti-discrimination law regarding

sexual  affinity through  policies  that address workplace harassment.  It has provided

‘accommodations’ to offset physical disabilities, including for example ramps to allow people in wheelchairs to have access to workplaces and using screen-readers or other devices to assist people with eyesight problems.

Those accommodations are a matter of respect, an entitlement of all Australians, irrespective of difference and independent of background.

They also make sense in terms of national productivity and the tax base, given that individuals

and the community  benefit when people  are  contributing  to the economy through

employment. That participation is important both for individuals and their families. In a society that values self-sufficiency there are few things more dispiriting than being denied the opportunity to work when people are eager to work and aware that how they are perceived is often dependent on whether, to use the words of Joe Hockey, they are ‘lifters or leaners’. A core function of government is to assist people to become those ‘lifters’.

One basis for that assistance is community awareness of the autism spectrum, discussed below, which includes the Commonwealth government ‘walking the talk’ in providing an example to other employers by respecting diversity.

Another basis is action to change work practices and facilities to enable performance by many people on the spectrum. Change encompasses practical mechanisms such as flexibility in working hours and scope for working from home, alongside changes to the layout of public sector offices. Perhaps ironically, many people who are not on the spectrum would strongly

endorse a move away from what has become the standard ‘cubicle farm’ layout of offices, an environment in which people with strong analytical or other skills are distracted and discouraged through noise, poor lighting, movement and interruptions.15 That distraction makes life unpleasant for people who are not on the spectrum. It can be career-limiting for people who are on the spectrum, given that it affects both their performance and well-being.16

Over many years there have been claims by management theorists, managers, vendors of office fitouts and property owners that it is essential that all office work be done from ‘offices’, with the layout of offices being as much a matter of fashion – for example the current vogue for bench-style ‘hot desks’ – as it is of functionality.17 Working in an office has been a signifier of status alongside a mechanism for bureaucratic supervision. There is little objective evidence to support assertions that the open office plan is both most efficient and productive of the greatest amount of innovation or accountability.

An ironic outcome of COVID-19 has been a demonstration that public and private sector organisations were able to function effectively with employees working from home. There was no substantive loss of accountability and after the initial period many employees report increased job satisfaction and productivity.

In considering the Commonwealth’s importance as an exemplar of best practice regarding people on an autism spectrum it is therefore appropriate to –

expressly recognise neurodiversity through a service-wide policy statement
on a department/agency by agency basis conduct an internal review of how that policy has been implemented, through for example information initiatives and scope for individuals to work outside standard cubicle farm/hot desk layouts (including working from home)
agency-specific and service-wide reporting about achievement of the policy, through for example both agency annual reports and a consolidated report that enables public scrutiny and employee benchmarking.

The Commonwealth has underpinned anti-discrimination policies through a recognition that the public sector is a major consumer of goods and services. Its significant purchasing power has accordingly been reflected in a choice not to purchase from businesses that engage in egregious discrimination regarding ethnicity, religion, gender or sexual affinity.

As a corollary of the measures identified in this submission I suggest that the Committee consider the scope for the Commonwealth to exclude businesses that disregard neurodiversity.

15 See for example Matthew C Davis, Desmond J Leach and Chris W Clegg, ‘The Physical Environment of the Office: Contemporary and Emerging Issues’ in G P Hodgkinson and J K Ford (eds) International Review of Industrial and Organizational Psychology (Wiley, 2011) 193; and Nick Perham, Helen Hodgetts and Simon Banbury, ‘Mental arithmetic and non-speech office noise: an exploration of interference-by-content’ (2013) 15(62) Noise Health 73. 16 See in particular the discussion in Bruce Baer Arnold, Patricia Easteal, Simon Easteal and Simon Rice, ‘It just doesn’t ADD up: ADHD/ADD, the workplace and discrimination’ (2010) 34(2) Melbourne University Law Review 359. 17 Nikil Saval, Cubed: A secret history of the workplace (Anchor Books, 2014); Kathryn Lofton, ‘The Spirit in the Cubicle: A Religious History of the American Office’ in Sensational Religion: Sensory Cultures in Material Practice (2014) 135; and Renyi Hong, Office Interiors and the Fantasy of

Information Work’ (2017) 15(2) tripleC: Communication, Capitalism & Critique. Open Access Journal

for a Global Sustainable Information Society 540.

Community Awareness Preceding pages have indicated that many people misunderstand neurodiversity and construe individuals on the autism spectrum as having a fundamental deficit. Being labelled as autistic is pernicious. Many ‘high functioning’ people on the spectrum accordingly choose not to publicly identify as autistic.

Increased community awareness is one feasible and necessary response to that

misunderstanding, stigma and exclusion.

At the beginning of this submission I contextualised ‘deficits’ by noting that women in Australia were for many years objectified as deficient and therefore excluded from full participation in commerce, public administration and society. We have progressively recognised the inappropriateness of that objectification, in part through community education and in part through the exemplary lives of female judges, governors, members of the Australian Defence Force, academics and corporate executives. Australia has been the better for that recognition.

Enhanced community awareness of neurodiversity will produce the same benefits and will foster the willingness of exemplary people on the autism spectrum to publicly identify as being on that spectrum, thereby providing an inspiration to peers and a demonstration to others that the spectrum is not synonymous with incapacity or other deficit.

That awareness is a matter of provision of information through the education curriculum at the primary and secondary school levels. It is also achievable through community information campaigns. The national government over many years has invested in such campaigns for public benefit and to substantiate Australia’s claims to respect obligations under the global human rights framework.

Such awareness, as noted below, will underpin public recognition of the legitimacy of updating Australia’s human rights statutes at the Commonwealth, state and territory levels. Australia’s history with public support for statutory mechanisms to address gender-based discrimination, for example through the Sex Discrimination Act 1984 (Cth) and the Anti-Discrimination Act 1977 (NSW), indicates that what might initially be controversial is seen within a decade to be quite unremarkable.

Education I have referred to a spectrum because people identified as ‘autistic’ are individuals, deserving of respect as such and with a range of capabilities, strengths and challenges. Those challenges may vary over an individual’s lifespan and may be especially prominent during childhood.

Although there is no comprehensive data, it is clear that may young people on the spectrum experience bullying at and around education. Particular behaviours may attract targeting by peers. More broadly, children and teenagers who are on the spectrum may find that bullying is both especially distressing and exacerbates the awkwardness that initially results in targeting.18

18 Suzanne Carrington, Marilyn Campbell, Beth Saggers, Jill Ashburner, Fiona Vicig, Julie Dillon-

Wallace and Yoon-Suk Hwang, ‘Recommendations of school students with autism spectrum disorder and their parents in regard to bullying and cyberbullying prevention and intervention’ (2017) 21(10) International Journal of Inclusive Education 1045; and Paul R. Sterzing, Paul T. Shattuck, Sarah C.

Narendorf, Mary Wagner and Benjamin P Cooper, ‘Bullying Involvement and Autism Spectrum

Disorders: Prevalence and Correlates of Bullying Involvement Among Adolescents with an Autism

Spectrum Disorder’ (2012) 166(11) Archives of Pediatrics and Adolescent Medicine 1058.

That bullying should be expressly recognised in the National Safe Schools Framework, underpinned by the curriculum change referred to above. It should not be addressed by labelling that signifies everyone on the spectrum is deficfient, ill or abnormal. In essence, to use the words of neurodiversity advocate the Australian education system should be working to ‘create inclusive communities where autistics can flourish with (and perhaps because of) their autism, not trying to turn autistics into nonautistics’.

There is substantial research to the effect that teaching of children on the spectrum should be integrated with the teaching of their peers, rather than relegated to ‘special needs’ classes.19 That requires expertise on the part of teachers and support for those teachers, with any ‘National Autism Strategy’ involving meaningful funding in the education sector.

A corollary is support for parents, recognising that not all minors on the spectrum have the same attributes and that the manifestation of attributes in an individual may not be constant.20

That  support  should  not  be  derided  as  ‘middle  class  welfare’.  Irrespective  of  the

Commonwealth’s concern for human rights, there are strong economic arguments in terms of strengthening national productivity and the tax base by assisting parents and thereby enabling them to fully participate in the workforce.

Justiciable Rights Australian governments are quick to refer to ‘rights’, as if that reference solves all significant problems. In practice rights must be justiciable: enforceable at law by (or on behalf of) people whose rights have been disregarded because those rights are deemed to be less important than bureaucratic convenience. Individuals at the most disadvantaged end of the spectrum are, regrettably, often going to face major challenges in voicing their rights and securing respectful support in the face of administrative indifference, medicalisation of ‘deficit’ or claims that assistance would be inordinately expensive.21

In strengthening the rights of people on the spectrum and their families it is accordingly necessary to engage in statute reform, including a justiciable constitutionally-enshrined Bill of Rights.

It is also necessary to adequately resource agencies at the national, state and territory level such as the Australian Human Rights Commission, the Commonwealth Ombudsman and Victorian Ombudsman. In the absence of resourcing we place an undue burden on people who experience discrimination on the basis of substantive/perceived difference, with the result that our justice system resembles a Potemkin village in which disadvantage is perpetuated rather than alleviated.

19 See for example Jennifer A Kurth and Anne M Mastergeorge, ‘Academic and cognitive profiles of students with autism: Implications for classroom practice and placement’ (2010) 25 International Journal of Special Education 8; and Jennifer Lyons, M Catherine Cappadocia and Jonathan A Weiss, ‘Brief report: Social characteristics of students with autism spectrum disorders across classroom settings’ (2011) 17 Journal on Developmental Disabilities 77. 20 Jennifer Couper, ‘Who should pay for intensive behavioural intervention in autism? A parent’s view’ (2004) 40(9/10) Journal of paediatrics and child health 559. 21 See for example Victorian Ombudsman, Investigation into the management and protection of disability group home residents by the Department of Health and Human Services and Autism Plus (Ombudsman Report 8, 2017).