“You shall love the Lord your God with all your heart, and with all your soul, and with all your mind, and with all your strength… and your neighbor as yourself.” (Mark 12: 28-31)
In September of 2013 Autism Speaks wrote an editorial about the most recent Census Bureau report (http://bit.ly/2aUmwKc ). The latter report found that more than 1 in 5 children within the United States were living in poverty (http://bit.ly/IL3py4 ). For children with disabilities poverty translates into a disadvantage in terms of getting both access to early screening and required health services. Although race and socioeconomic level are not predictive of autism, there is a substantial bias in the United States as to whom we identify as autistics. Under the Individuals with Disabilities Education Act schools are called to screen for autism but the same seem to misidentify those autistic children that are Afroamericans and/or Hispanic (Travers et al., 2012).
The consequences of socioeconomic and racial/ethnic disparity for disabled children gets worse as we consider all of the research pointing towards better outcomes for those with early interventions. In this regard Autism Speaks instituted an initiative called Early Access to Care (EAC) wherein people in their administration are working closely with community-based organizations to ensure the distribution of resources among those that need it the most. In addition to this hands-on approach, EAC is also an advocacy movement that promotes the access of evidence-based early interventions to children through health insurance reform including Medicaid-covered services.
It can’t be denied that socioeconomic status such as parental income are strongly correlated with the health and development of children (Susser et al., 1985). In this regard it has been suggested that, “more parents of high social class families [have] the necessary information and financial resources to dig their way to the specialized facilities” (Tsai et al., 1982). The fact that we are failing in our obligations to equiparate services for disabled children calls into question the ethics by which funding governmental organizations are working. The government and health care professionals work under the ethical principle of beneficence where the ethical treatment of all involved individuals and the attempt to secure their well-being is not only seen as moral directive but, more so, as an obligation.
When thinking about the vast reality of disabled children we have to cross the divide between our own situation and those living in poverty. This way of thinking helped formulate the United States as a nation when in the preamble to the Constitution we pledged to promote, “the general welfare” of our people, and made it a core reason why we constituted ourselves as a nation. Congress was therefore granted the ability to spend money (from taxes) in ways limited to those that benefited the welfare of the whole nation (http://www.learntheconstitution.com/social-welfare.html ). The Constitution was amended based on the 1936 Butler case so that general welfare was properly understood not as collective needs but also those of certain states or certain people (e.g., the poor or the disabled).
Poverty is not about negatives and stereotypes (e.g., minorities, drugs, welfare). Poverty is about lack of educational opportunities (including childcare), teaching appropriate skills for a given grade level, having teachers that have the time to care for their students, implement appropriate subjects like music and have laboratory equipment, and about the availability of after school and summer programs. Poverty is about lacking a decent place to live. Waste management industries are constructed near poor neighbors, not rich neighborhoods. There is no “affordable” housing when you are very poor. Disabled children from disadvantaged neighborhoods may not be able to play outside as they are told it is dangerous. However, their disabilities also may prevent them from playing outside in schools, a virtual double hit on their socialization skills.
Sometimes poverty behaviors are criminalized, e.g., sleeping in benches, homelessness. A person in poverty lands in jail and still fails to get assistance in terms of finding a job or dwelling. In effect our laws often remove the person and the “inconveniences” they may present to society but do not give them the tools to make them self-sufficient.
Children are deeply impacted by the employment of the parents, and later on by their own employment. Unfortunately these are all complex components of welfare and there is no one single thing to do that will make their life better. In Greenvile SC, where I live there is a program called “Our Eyes Were Opened” (http://oewo.org/) that teaches you to think with the community and not for them. It teaches you to develop roots in your community by working together as a team. Our Eyes Were Opened provides for poverty simulations, poverty tours, teen job fair simulations and medical access simulations. While the government takes its time to take care of our disabled and poverty stricken children, it is our duty to do justice and walk humbly side by side with our less fortunate brothers and sisters.
Susser MW, Hopper K, Watson W. Sociology in Medicine, 3rd edition. Oxford University Press: New York, 1985.
Travers JC, Krezmien MP, Mulchy C, Tincani M. Racial disparity in administrative autism identification across the United States during 2000 and 2007. J Spec Edu 48(3):155-66, 2012.
Tsai L, Stewart MA, Faust M, Shook S. Social class distribution of fathers of children enrolled in Iowa program. J Autism Dev Dis 12:211-221, 1980.