“Autism Rehabilitation” in China

A couple of weeks ago I went to Beijing to provide a keynote lecture at an autism congress. I had made previous commitments for the time frame of the congress but a friend heavily insisted and asked my attendance as a personal favor. It was a curious conflict as I was scheduled to participate in an Autism Research Institute Think Tank, of which I am a member of their Scientific Advisory Board, and a congress in Russia which I have been forced to miss despite my best intentions to attend during the past 3 years.

The congress in Beijing was sponsored, in part, by the International Consortium of Autism Institutes (ICAI) of which I serve as president.  The same was curiously entitled “Autism Rehabilitation”. The name itself would have drawn objections in the United States and Europe where Neurodiversity advocates argue against both research and treatment for autism. By way of contrast, in Russia and China, autism is regarded as a medical disorder and talking about treatment and/or rehabilitation is readily embraced by autistic individuals as well as the government.

This was a rather short trip of 5 days, 2 of which were travel related. In the remaining 3 days I participated in the congress, visited 2 universities, the laboratories of several friends, and a hospital.  I also met with many government officials, all of whom coincided in saying that autism was a major initiative within their country. As a first step they are conducting one of the largest epidemiological studies in the world by looking at the prevalence of autism in their country. The government was also funding many of the initiatives that I was able to witness during my trip: the congress, a Magnetic Encephalograph Center, a Key Laboratory in Cognitive Neuroscience, and the Beijing Rehabilitation Hospital.

I was happy to see that at the Key Laboratory in Cognitive Neuroscience that they were using transcranial magnetic stimulation (TMS) for the treatment of autism, and that the protocol is the same we have developed in the United States. TMS is making many inroads in China, mostly propelled by their expertise in electronic engineering and the low wages for technical labor. I saw a variety of portable TMS devices, which in the US are devoted to the treatment of migraine. In China, portable TMS devices, were more powerful (higher magnetic field) and were being used for different mental disorders.  I also saw a large variety of transcranial direct current stimulation (tdcs) devices that were being sold for less than $100. In the US, some of the commercially available tdcs devices sell for about $900 and more.  It seemed like a remarkable low price, however, I can’t attest for the quality of the electrical components used in their manufacture or whether they had been reversed engineered and probably at odds with our patent laws.

More than anything else during my travel I was impressed by the capabilities of the Beijing Rehabilitation Hospital. The physical rehabilitation ward had some 80 technicians (not including students) and received 700 patients daily. The ward was opened all day and for most of the night, and there was a second shift of employees coming to work during the evening hours.  The clinical wards and hospital visits were also opened Saturdays and Sundays.  The hospital excelled in prosthetics and enjoyed a world-wide reputation as I saw many patients from different countries receiving services there.

The Beijng Rehabilitation Hospital also housed one of the biggest providers of autism related services that I have seen. There were specialized rooms for music therapy, play therapy, desensitization massages of various kinds, speech therapy, and acupuncture. Applied Behavioral Analysis is making inroads in China and 40 patients were receiving the same in one of the hospital’s clinics.

The large variety of services at the Beijing Rehabilitation Hospital was available to all people in China regardless of their geographic origin. Services were provided for free but you could also arrange for them and pay directly. In this regard, if somebody thought that their child could benefit from some services that had not been recommended by their physician (e.g., music therapy), they could pay for it themselves.

IMG_0495

One of the places we visited was the China Autism Rehabilitation Research Center (see the picture of the brass plaque above). In China, autism is regarded as a medical condition, one that merits research. This approach would lead to condemnation by the Neurodiversity community within the United StatesIMG_0486It appears that most of the socialization in China happens over sumptuous meals. Nothing that we ate was repeated.During my stay in China, I had the opportunity to share a meal and enjoy a discussion with dozens of graduate students.

IMG_0463The audience at one of my lectures was packed primarily with parents and providers.  I was surprised by the wide-range of questions following each lecture.

IMG_0490Even the small universities in Beijing look gigantic. This is the Beijing Language and Culture University which houses a modern MEG Center.

IMG_0481The introduction to the congress publicized the sponsoring organizations, one of which ICAI, I serve as the president.

IMG_0465Some of the presenters at one of the meetings. I stand in the middle and my good friend Tato Sokhadze on my left.

8 responses to ““Autism Rehabilitation” in China

  1. Veo que el movimiento de la neurodiversidaden EEUU (al igual que en otros lugares) se caracteriza por tener algunos sectores ciertamente radicales. Muchas veces se da la paradoja de que las personas que más se oponen a las intervenciones para paliar los síntomas incapacitantes del autismo, a su vez sí han sido beneficiados por estos tratamientos. De hecho, curiosamente el propio Jim Sinclair -uno de los fundadores de la ARN- se graduó y ejerció como terapeuta de rehabilitación para personas con autismo.

    De todos modos, no debería usted envidiar ni tomar como ejemplo la perspectiva y la situación con respecto al autismo que existe en China. En ese país, cualquier movimiento parecido al de la neurodiversidad (en cualquiera de sus versiones, desde las más extremas a las más moderadas) sería considerado como un elemento subversivo, y sus integrantes tratados como auténticos terroristas. En China se persigue cualquier idea que se presuma como contraria al régimen imperante o a la moral del partido gobernante. Y en esta persecución de las ideas disidentes están incluidos los campos de detención, tortura y ejecución que en este país tienen por cárceles y en donde se practican terribles violaciones sistemáticas de los derechos humanos (soy miembro de una organización de defensa de los DDHH). . Aunque doy por supuesto que este tipo de “asuntos internos”, tal y como los denominan, no se muestran abiertamente a las visitas.

    Lo que le quería decir es que, al igual que ocurre en el conocido cuento de “Las mil y una noches”, muchas veces hay que tener mucho cuidado con lo que se desea, porque tampoco todo es tan bonito como aparenta. Un cordial saludo

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  2. Le agradezco la oferta, pero tampoco es cuestión de derivar la temática de su blog hacia cuestiones relacionadas con la represión y las desigualdades que se producen bajo determinados regímenes. Únicamente pretendía señalarle que la realidad en este país tiene múltiples contradicciones que van más allá de las bonitas escenas, posiblemente un tanto artificiosas, que ha reflejado usted en el artículo sobre su visita a China.

    Detrás del escenario están las paúperrimas condiciones en las que viven las personas del ámbito rural (la mayor parte de la población de este país) o las terribles circunstancias que se denuncian en determinadas instituciones como los orfanatos y psiquiátricos, donde abunda la desnutrición, la falta de cuidados, los abusos y el maltrato.

    Cuando se terminó la actuación y usted volvió a su país honrado y agasajado -ciertamente agradecido y encantado por el trato y la atención recibidos- el telón bajó hasta el suelo ahogando con su peso el dolor y el sufrimiento de todos los seres humanos que viven bajo el yugo de esta tiranía.

    No pretendo en ningún caso ofenderle ni enfadarle, por el contrario le respeto y le admiro en muchos sentidos (ya sabe en cuales). Pero considero una obligación el advertirle que estos regímenes utilizan con una gran maestría estrategias de manipulación y persuasión frente a las delegaciones extranjeras, hábilmente desarrolladas con la finalidad última de crear un clima de opinión favorable a los intereses de su gobierno, a la vez que tratan de esconder sus vergüenzas: el hecho de que le ofrecieran tanta comida no es casual, por ejemplo. Precisamente ésta es una de las prácticas de difusión y propaganda política encubierta que se denuncian desde las organizaciones de defensa de los DDHH.

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    • Mchas racias port tus comentarios y el tiempo que has ofrecido en proveer las mismas. Considero tu opinion una muy importante y por eso era que crei que podias expandirala en un blog. Gracias por tu participacion.

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  3. I can also relate to the enjoyment of being treated to meals in China. Dinner after dinner, feast after feast, every host or friend was generous. The most remarkable aspect is the surprise for many foreigners of the absence of rice up in Beijing where it is cold. Plates of dishes I don’t care to know what the name is! It’s tasty enough that I don’t care!

    I have lived in Asia for months at times and what I have seen is:
    There is less or no neurodiversity and pride, but less genuine activism. If there are groups for their rights, its legitimate. (Rights of the person with autism, not to be confused for rights for autism, I used to watch both Ted and Tedx talks, but stopped tedx after neurodiversity or anti psychiatry version 2.0 became popular). The attitude of the majority is mostly indifference or just pretending it’s not there, even for physical ailments people will smoke and smoke but when they cough or feel a lump on their tongue, they are pressured by society to put off seeing a doctor. (Unless you are rich enough to go on your own, too many people will not share even if they go)

    People say doctors will do their research regardless of what some of the public think. Movements like neurodiversity may not hinder progress but can prevent extra or bonus progress from being made that could have been. Any attempt of something like the ice bucket challenge for ALS except for autism is destroyed or not allowed. You will get your social accounts filled with angry mail. They aren’t holding it back, but are preventing opportunities for an extra step every so often there is one.

    Perhaps indifference without denial and realism, and not politicizing a condition, and leaving it to the experts leads to the best results. If Asian countries removed that one bad quality of ignoring illnesses but kept the same common sense neutral attitude and let a little genuine activism in, they would be set for being a good model.

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  4. An interesting description of the chiness people at the “day by day”, Hans. I enjoy it very much! They have an very old and very complex culture.
    I supose the indifference they show about private questions is a way for avoid possible conflict sources. I don´t think they have bad intentions. I know some chinesse people and, in my opinion, they don´t are a “cold persons” than -in a first impression- they can seem.

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  5. Even though it’s not researched here in the United States as a medical condition, it is still studied, and we are working on remedies and therapies to help cure autism in children and adults. One big difference is the refrainment from pharmaceuticals in autism research- most of the reseach for children comes from therapies such as play therapy. As a “medical” problem, it would be easier to research drugs, as opposed to therapies to manage autism

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  6. There are some obstacles for the medical research of all brain pathologies in the whole world´s occidental region, because there is a black legend about “physical” methods in the collective subconscious. Remember for exemple electroshock, lobotomy or others types of surgery.

    Accordingly, I have the impression that one of the handicaps of TMS in the way to be accepted as a valid treatment for autism is the use of the concept “transcraneal”. I think it could have certain connotations (semantic or symbolic associations) with this type of neglected procedures. Of course, this is only a personal opinion.

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