ADVANCE PRAISE FOR

The Autism Industrial Complex: How Branding,

Marketing, and Capital Investment Turned Autism
Into Big Business

“This is such a smart book, one that I and so many others have been seeking. Exhaustively
researched, The Autism Industrial Complex: How Branding, Marketing, and Capital Investment
Turned Autism into Big Business brilliantly lays out the onto-epistemological stakes of the
entwinement of autism and capitalism. Broderick historizes the how and why of the
commodification of autism, providing a jarring critique of the neoliberal logics of inclusion and
intervention. The AIC is a tour de force; I cannot wait to teach it.”
Jasbir Puar
author of The Right to Maim and Terrorist Assemblages

“This is truly innovative work. It sends a critical lightning bolt into the enormous professional
industry of autism that has tendrils sunk into university departments of medicine, rehabilitation,
psychology, and education. Notions I’ve only half-wondered about this book puts together so
well, so clearly, and with such detail that the readers will experience either satisfaction because
they knew something was awry here or discomfort at the sheer scale of the problem.”
Scot Danforth, PhD
Professor, Disability Studies and Inclusive Education,
Assistant Dean of Research
Chapman University

“Autism is at an inflection point today. We are poised for a paradigm shift in autism research,
education, and therapies; this book initiates that shift, and does so superbly. In The Autism
Industrial Complex: How Branding, Marketing, and Capital Investment Turned Autism into Big
Business, we learn about the history and evolution of this multi-billion dollar/year operation.
Thanks to this history, we will remember Lovaas, ABA, and behaviorism in general not as a
science, but as a branding, rhetoric, and marketing plot that transiently misguided many well-
intended parents and professionals, and that in so doing profited with greed, by preying on our
human hopes, our trust in science, and our fears.”
Elizabeth B. Torres, PhD
Professor & Computational Neuroscientist, Rutgers University
Principal Investigator, New Jersey Autism Center of Excellence (2018-2023)

“In this exquisite analysis of the Autism Industrial Complex (AIC), Broderick leads her readers
through a complex and nuanced argument that begins with the straightforward premise that
‘autism is a construct inscribed upon, experienced through, and materialized by the bodies of
autistic people.’ Her critique is richly informed by the intersection of social, historical, cultural,
political and economic infrastructures that ‘produce and sustain autism as a lucrative
commodity.’ Broderick, with great detail and critical insight, reveals the unfortunate impact of
behaviorism as an ideology that has, for too long, held a stranglehold on our understanding of
autism as little more than a scorecard of deficiency and lack. This book strengthens the
arguments of those who advance alternative frameworks to understand autism in particular and
disability in general. In so doing, it will undermine the institutions we have created to mine
difference as problem.”
Linda Ware, PhD
Independent Scholar
 The Autism
Industrial Complex
 The Autism
Industrial Complex

How Branding, Marketing, and

Capital Investment Turned Autism
Into Big Business

By Alicia A. Broderick

GORHAM, MAINE
Copyright © 2022 | Myers Education Press, LLC

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DEDICATION

For Michael, Nicholas, and Robin,

with love

In memoriam:
Bill Newell, for teaching me to think interdisciplinarily
and
Steve Taylor, for encouraging me to “enter the fray”
CONTENTS

Acknowledgments

Foreword – Anne McGuire

Part One: Forging The Autism Industrial Complex: Manufacturing Foundational

Commodities (1943–1987)
1. Autism, Inc.: The Autism Industrial Complex by Alicia A. Broderick and Robin Roscigno
2. Consuming Autism as Social Problem and the Cultural Logic of Intervention by Alicia A.
Broderick and Robin Roscigno

Part Two: (Re)Branding and Marketing the AIC: Manufacturing Markets,

Consumers, & Consumer Confidence (1987–present)
3. Rhetoric and Neoliberalism: On (Re)Branding and Consuming Hope
4. The Politics of Hope: Autism and “Recovery [to Normalcy]”
5. The Politics of Truth: Deploying Scientism in ABA Rhetoric
6. The Politics of Fear: The Fires that Forged the Economic Apparatus of the AIC

Part Three: The Economic Apparatus of the AIC: Incorporation, Legislation, and
Capital Investment (1998–present)
7. Intervention, Inc.: Nonprofit Corporations and Venture Capital
8. Prevention, Inc.: The Cultural Logic of Prevention, Basic Research, Hedging Bets, and
Perennial (re)Branding

Part Four: Autism and Biocapital: On Precarity and Futurity

9. Autism and Biocapitalist Emergences: Biopolitical Technologies of Control
10. On Being Autistic in Neoliberal Capitalist Ruins: Endemic Precarity and Autistic Futurity

About the Author

Index
ACKNOWLEDGMENTS

T HIS BOOK IS PERHAPS aptly described as what the Great Lakes Feminist Geography Collective
calls “slow scholarship” (Mountz et al., 2015), which may be an understatement, as it
represents the present culmination of the gradual evolution of my own thinking and scholarship
on the cultural politics of autism over the course of approximately two decades. I published
several pieces of scholarship advancing this line of thinking over the years, in what I understood
to be nascent, emergent, and partial forms, as the demands of the neoliberal university require
not deep, complex, or comprehensive, but rather, frequent, regular, and visible publication.
Portions or earlier versions of the following chapters have previously appeared in print in
other publication venues:
An earlier version of Chapter One and an earlier version of a short passage in Chapter Ten
were previously published as “Autism, Inc.: The Autism Industrial Complex” in the Journal of
Disability Studies in Education, (2021), 1–25. https://doi.org/10.1163/25888803-bja1000 ©
Alicia A. Broderick & Robin Roscigno. Part One was written with the collaboration of my
colleague, Robin Roscigno.
Earlier versions of parts of Chapter Four, “The Politics of Hope: Autism and ‘Recovery [to
Normalcy]’” were originally published under the title “Autism, ‘Recovery [to Normalcy],’ and
the Politics of Hope” in Intellectual and Developmental Disability, (2009), 47 (4), 263–281.
Reprinted with permission.
Select passages in Chapters Three, Five, and Seven were previously published, in earlier
versions, in 2011 in Disability Studies Quarterly, 31(3) in a manuscript titled “Autism as
Rhetoric: Exploring Watershed Rhetorical Moments.” https://dsq-sds.org/article/view/1674/1597
© Alicia A. Broderick.
My Part One coauthor, Robin Roscigno, and I met under serendipitous circumstances (from
my perspective; from Robin’s, the circumstances were certainly strategic, and in hindsight [from
my perspective again], deftly precipitated). Following a long period of chronic personal and
professional stress, I had retreated to a (metaphoric) cave for a couple of years and simply
stopped going to professional conferences and other social/professional venues where I typically
met emerging scholars in the field and reconnected with longtime colleagues and friends. And in
truth, I didn’t write much (at least, not much that I cared about). Then I got a cold email from
Robin. I almost never respond to cold emails (and I’ve never taken a cold phone call in my life),
but this one was different from the usual sort (and no, I’m not going to tell you how, lest you try
to contact me yourself), so I responded. Suffice it to say, Robin got my attention, and kept it, and
we began meeting, and talking, and reading together, and not long after, writing together. Thank
you, Robin, for waking up my brain again, for being my muse, for knowing exactly how to finish
my sentences and for letting me finish yours. Working with you has been like working with my
own younger self, if my younger self had known back then what I know now 20 years later, but
still had some energy and vitality left in me. Our collaboration has been soooooooo very I N T E
R E S T I N G. Thank you for that.
To my colleagues and friends (some of whom are both), I much appreciate your conversation
and prodding and listening and support over the many years that these ideas have been
percolating in my head. Many of you listened politely, not having any earthly idea what I was
talking about, but just letting me talk through the ideas out loud nevertheless was helpful to me.
Thank you for listening (and/or pretending to). You know who you are and I won’t list you by
name, as I’m much more private than you are, and so you, in this case, shall be as well. But I
nevertheless thank you, with all sincerity, from the bottom of my heart. My special thanks to
Anne McGuire for penning the foreword, and for very helpful suggestions on an earlier draft of
this manuscript; and additional thanks to Jason Toncic and Michaella Toumazou for research
assistant/editorial support with several chapters. And my sincere thanks to Scot Danforth, not
only for his useful feedback on an earlier draft of this manuscript, but also for his enthusiastic
and steadfast support and encouragement of this line of my scholarship, dating all the way back
to my somewhat rocky initial attempts to get my dissertation proposal approved. To my editor,
Chris Myers, and all the fabulous staff at Myers Education Press, thank you for being such kind
and patient humans, for never stressing me out by reminding me how far behind deadline I was (I
took care of that myself), and for gently insisting that I cut 10,000 words from my original
manuscript (it’s a better book for it).
Lastly, and most importantly, to my family—to Nicholas and Robin, I have been in the
process of birthing this book through the entirety of your now 19- and 16-year-old lives. It’s
been your second sibling that’s often taken me from you when you may not always have
understood why. Thank you for always being there with open arms and minds and hearts when I
emerged from my writing, ready to mother you again. And Michael—I’m not sure how you’ve
put up with my splitting my attention all these years, with so much of our joint parenting falling
disproportionately upon you while I was absent (physically, or mentally, or emotionally, or all
three). My gratitude is profound, and my love, more so. (And no, I won’t make you read it, but
you can if you want to . . .).
Every piece of writing is collaborative, and is inherently borne of not only the thoughts and
ideas and keyboard of the writer and her cowriters, but also all of her experiences and
relationships, personal and professional. And while these ideas could not have been documented
in this way without all of those experiences and all of those people, the text is still inherently
partial, incomplete, and a snapshot (however cumulative) in time. Nonetheless, all errors,
omissions, not-quite-yet-understandings, and other imperfections are my own, and I take full
responsibility for them, since I’m the one that decided to commit them to print at this moment in
time. I hope that there may be a few others in the world who find these ideas as interesting as I
do. If you are one of those people, then this book was written for you.

References
Mountz, A., Bonds, A., Mansfield, B., Loyd, J., Hyndman, J., Walton-Roberts, M., Basu, R., Whitson, R., Hawkins, R.,
Hamilton, T., & Curran, W. (2015). For slow scholarship: A feminist politics of resistance through collective action in the
neoliberal university. ACME: An International Journal for Critical Geographies, 14(4), 1235–1259. https://www.acme-
journal.org/index.php/acme/article/view/1058
FOREWORD

W ITH THE AUTISM INDUSTRIAL Complex: How Branding, Marketing, and Capital Investment
Turned Autism into Big Business, Alicia Broderick takes on the business of autism under
neoliberal capitalism. First and foremost, this book is distinguished by its refusal to be limited to
any one-dimensional consideration of the autism industries. Scratching beneath the surface of
these industries, Broderick exposes a diffuse and evolving underlying infrastructure—
epistemological, ontological, ideological, rhetorical, discursive, bureaucratic, and legislative.
This is the architecture that lies at the heart of Broderick’s articulation of an Autism Industrial
Complex (AIC), a system that, she shows us, works to manufacture autism as a commodity while
simultaneously establishing and legitimizing its markets. Broderick’s analysis contends that the
AIC, bound by powerful and dangerous interventionist and preventionist logics, transforms all
that is autistic—bodies, minds, senses, modes of relating and ways of being—into raw materials
ripe for profit extraction. Of course, for autistic people, the cost of this kind of
economic/extractive relation is all too high, leaving little room for autistic agency or alternate
modes of being or relating and harmfully seeking to stamp out any and all forms of autistic
growth and flourishing that cannot be captured and calculated by capital.
I first encountered Broderick’s work on autism when I was researching and writing my book,
War on Autism: On the Cultural Production of Normative Violence (2016). Published in 2008,
the pathbreaking essay by Broderick and coauthor Ari Ne’eman, “Autism as Metaphor,”
uniquely captured the zeitgeist haunting the cultural landscape of autism during the first decade
of the 21st century. At a time when autism was scarcely studied as a cultural phenomenon in
academic spaces, Broderick and Ne’eman astutely identified a set of powerful rhetorics that told
limiting—and often outright violent—stories of autism as a kind of shell, an alien or foreign
space, a social crisis, and a life-threatening disease in need of remediation and/or cure. Vis-à-vis
stories of autism as problem and pathology, Broderick and Ne’eman called for a centering of the
paradigm of neurodiversity. They provocatively asked:

if autism as neurodiversity were a more culturally dominant metaphor than autism as disease, how might it differently
inform the political and economic decisions that come into play in the constitution of culturally dominant ideas about
appropriate responses, interventions, or supports? (Broderick and Ne’eman, 2008, p. 474)

Over the years, Broderick has shown us glimpses into her evolving thinking on this question
(Broderick, 2009, 2010, 2011). In The Autism Industrial Complex, she provides us with her
unequivocal response: the mainstreaming of neurodiversity alone can and will never be enough
to destabilize the powerful cultural and economic structures that continue to profit off of autism’s
assumed problem status and its perceived need for remediation or else elimination. In my view,
one of The Autism Industrial Complex’s best and most exciting offerings lies in its provision of a
unique set of critical insights and analytic tools, key resources that will be invaluable to anyone
seeking to navigate the murky waters of autism’s tentative and differential inclusion within
neoliberal cultures and markets of (neuro)diversity.
The cultural landscape of autism has no doubt changed dramatically over the course of the
past 15 years. The intervening years have seen the amplification and indeed the flourishing of
autistic activisms and critical scholarship examining autism as, simultaneously, an identity, a
social relation, an art of resistance and an interpretive site through which we might learn a great
deal about our social, cultural, political and economic worlds. This activist labor has, among
other things, occasioned a notable shift in how nonautistic parents, professionals, organizations
and governments articulate autism in the mainstream. Nearly gone from view are the “shock and
awe” rhetorics of cure and crisis and of autism as a pathological foreign enemy in need of
militarized therapeutic response. The year 2014 saw the Bush-era Combating Autism Act recast
under the Obama administration, now assuming a distinctly more inviting name: the Autism
CARES Act. At the same time, major advocacy organizations like Autism Canada, the National
Autistic Society, and the Autism Society of America underwent significant rebranding processes:
the black-and-white images of stolen White children that came to define autism advocacy
advertising during the first decade of the 21st century were replaced with full-color portrayals of
an increasingly racially diverse cohort of children and adults drenched in smiles, rainbows, and
bubbles. And, perhaps most surprising of all, in 2016, the advocacy behemoth Autism Speaks
released a new and dramatically altered mission statement that seemed to let go of its brand-
defining narrative that characterized autism as a dangerous and spreading biological threat, an
“enemy within” that must be fought, contained, and defeated. Losing all references to crisis and
cure, Autism Speaks’s new statement optimistically refocused on “enhance[ing] lives today” and
“accelerating a spectrum of solutions for tomorrow” (Autism Speaks, n.d.). While such tonal
alterations might lead some to conclude that we have entered a new, more progressive era for
autistic people and their families, Broderick reminds us that the policies and practices advanced
by most public and private organizations remain to this day therapeutically- or else
preventatively-focused. In short, they continue to be oriented towards a decidedly nonautistic
future.
As we wade through more positive and inclusive permutations in the field of autism cultural
representation under neoliberal capitalism, The Autism Industrial Complex reminds us that we
are now confronted with a crisis of a different order: one of capital enhancement, differential
inclusion, and the corresponding stratification of resources, access, opportunities and, ultimately,
life-chances. Now—perhaps more than ever—we need complex, nuanced, and responsive
theoretical frameworks to better understand the mechanisms through which even the most radical
of the dreams and critiques of the neurodiversity movement are always at risk of becoming
incorporated, subsumed, and ultimately neutralized into yet another opportunity for capital
growth and profiteering. In this milieu, the import of Broderick’s rendering of the AIC cannot be
understated: it is a timely conceptual apparatus that well positions us to analyze the overt and,
increasingly, covert ways autistic people continue to be targeted for control and elimination even
amidst outward calls for acceptance and inclusion.
This work also and most crucially asserts the possibility of an otherwise. In its trenchant
critique of neoliberal and biocapitalist futures that promise a world in which autism no longer
exists, Broderick’s The Autism Industrial Complex orients us towards a decidedly autistic future
wherein we might take up the work of dreaming, growing, and nurturing a more livable world for
us all.
Anne McGuire, Associate Professor,
Critical Studies in Equity and Solidarity, University of Toronto.

References
Autism Speaks (n.d.). For the record. https://www.autismspeaks.org/Autism-Speaks-facts
Broderick, A. (2009). “Autism,” “recovery [to normalcy],” and the politics of hope. Intellectual and Developmental Disability,
47, 263–281. https://doi.org/10.1352/1934-9556-47.4.263
Broderick, A. A. (2010). Autism as enemy: Metaphor and cultural politics. In Z. Leonardo (Ed.), Handbook of Cultural Politics
and Education (pp. 237–268). Sense Publishers. https://doi.org/10.1163/9789460911774
Broderick, A. (2011). Autism as rhetoric: Exploring watershed rhetorical moments. Disability Studies Quarterly, 31 (3), n.p.
http://www.dsq-sds.org/article/view/1674/1597
Broderick, A., & Ne’eman, A. (2008). Autism as metaphor: Narrative and counter-narrative. International Journal of Inclusive
Education, 12 (5–6): 459–476. https://doi.org/10.1080/13603110802377490
McGuire, A. (2016). War on autism: On the cultural logic of normative violence. University of Michigan Press.
PART ONE

Forging The Autism Industrial Complex:

Manufacturing Foundational Commodities (1943–
1987)

W ITHIN CAPITALISM, THE AUTISM Industrial Complex (AIC) produces both autism as
commodity and the normative cultural logics of intervention and prevention in relation to
it. Comprising ideological/rhetorical as well as material/economic infrastructure, the AIC is not
the myriad businesses and industries that capitalize and profit from autism; rather, these
constitute its epiphenomenal features. In the production of autism as commodity, the AIC also
simultaneously produces that commodity’s market, its consumers, and its own monopoly control
of that market through production for consumption of need for, consent to, and legitimacy of
both interventionist and preventionist logics. Within this conceptual and ideological apparatus,
almost anyone can capitalize on and profit from autism. And within the AIC, autistic people—
their very bodies—function as the raw materials from which this industrial complex is built, even
as autistic people—their very identities and selves—also become unwitting, and often unwilling,
products of the AIC.
Part One charts and documents the building of the conceptual and ideological architecture of
the AIC over the course of the first four decades following the emergence of autism as an
ontological category in 1943. We present in Part One the conceptual heuristic of the AIC and a
historical excavation of the constitution of the AIC’s foundational ideological products: autism
(and autistic people) as commodities, and the normative cultural logic of intervention in relation
to it.
CHAPTER ONE

Autism, Inc.:
The Autism Industrial Complex
ALICIA A. BRODERICK AND ROBIN ROSCIGNO
A version of this chapter was originally published (2021) as “Autism, Inc.: The Autism Industrial Complex” in the Journal of
Disability Studies in Education.

D OMINANT METAPHORS IN POPULAR, media, academic, educational, and policy rhetoric about
autism for decades have centered on the constitution of autism as enemy, abductor, epidemic
contagion, alien, or otherwise dangerous and “other” (Broderick, 2010; Broderick & Ne’eman,
2008; McGuire, 2016). These metaphors have been explicitly deployed in the service of a
broader cultural narrative fueling “intervention” as the only sensible response to autistic people,
effectively exploiting ableist hopes and fears in the symbiotic production of the commodities,
markets, and consumers of the Autism Industrial Complex (hereafter, AIC) (Broderick, 2017;
Broderick & Roscigno, 2019, 2021). In the United States, much of the “educational” provision
for autistic students is provided by private schools and consulting firms, obviously profiting
(mostly through receipt of public dollars) from the dominant cultural metaphors about autism
and the interventionist narratives they sustain.
Autism narratives are being exported for global consumption through initiatives endorsed
and financially sponsored by the United Nations and the ubiquitous “philanthropic” media
behemoth Autism Speaks. State laws in the United States funnel both private and public health
insurance dollars straight into the revenue streams of behavioral consultancies, a business that
has boomed in the 20 short years since the institution of the Behavior Analyst Certification
Board, Inc.® (BACB®) as a body that draws its principal revenue from the certification of
multiple levels of behavior analysts. Autistic individuals (including, now, very young children)
collectively represent a vast market to be tapped and capitalized upon, a market for intervention
“technologies” to be levied by certified “behavior technicians.” There is money to be made in the
certification of behavior analysts—both for BACB as well as for universities who develop Board
Certified Behavior Analyst® (BCBA®) certification programs and run them as cash-cow tuition-
generating certificates, as well as for Pearson, who collects testing fees. There is money to be
made in contracts with school districts—a steady stream of mostly public dollars: state, local,
and federal Individuals with Disabilities Education Improvement Act funding—to employ ABA
consultancy firms, whose “technicians” are certified by the BACB, to deploy these interventions
in schools, thereby also exonerating districts from responsibility for altering the fundamental
structure of their curricula, their pedagogies, their teacher preparation, or the cultures of their
schools. And there is money to be made through health insurance reimbursement—also a steady
stream of both private and public money, facilitated by the active state-level lobbying that has
resulted, as of 2019, in the passage of boilerplate legislation in all 50 U.S. states constituting
ABA as the only “evidence-based,” and therefore only health-insurance-fundable, intervention
for autism.
In short, autism is big business.
Deploying both cultural and media studies and political economy as analytic frameworks, we
argue that the multiple intersecting branches of the AIC constitute, reproduce, and globally
export an effective monopoly not only of intervention services and products, but also (and more
importantly) of ideas and information publicly propagated about autism over the past several
decades. Ultimately, not everyone consumes autism intervention products and services, but it is
difficult to escape the consumption of (a) autism itself as commodified and circulated in media
and popular culture, and (b) its corollary interventionist cultural logic. The former market (in
which autism intervention products and services are consumed) is somewhat narrow in its scope,
but the latter market (in which autism and the cultural logic of intervention are consumed) is
pervasive and ubiquitous. And while the former comprises the autism industry, it is the latter that
constitutes the AIC.
Central to our methods is an extensive critical analysis of language and its devices
(metaphors, narratives, images, discursive and rhetorical tactics, etc.), ideologies and their power
dynamics (claims to legitimacy and authority and the deployment of “truth”), and the
bureaucratic, technocratic, and—crucially—economic institutionalization of these ideas through
the intersecting arms of the AIC apparatus under global neoliberal capitalism. This project makes
a crucial intervention into autism discourse, currently rooted in rhetorics of care and recuperation
(Helt et al., 2008), and material practices of bodily control and other forms of violence
(McGuire, 2016; Roscigno, 2020). We seek to excavate the specific historical, ideological, and
economic circumstances within which the AIC evolved, and in so doing, make the familiar—the
routine monetization of autism—strange and, additionally, to develop an analytic sufficient to
account for the present-day scale, profitability, and ubiquity of the AIC.

Autism and Capitalism

Relatively little scholarship in the past several decades has addressed the political economy of
disability generally. Whole bodies of scholarship have critically explored, for decades and in
various ways, the social and cultural production of disability; however, a few pieces distinguish
themselves from that larger body of literature by documenting the simultaneous production of
disability in a political economy—specifically, in the advanced neoliberal capitalist economy of
the United States. A key early analysis of the economy of disability is Gary Albrecht’s (1992)
The Disability Business: Rehabilitation in America. In this comprehensive analysis of the
rehabilitation industry, Albrecht candidly and explicitly explores the ways that disability became
“big business” in the late 20th century. His analysis explores the twin processes at work
establishing the disability industry: (a) the “production of disability” as “the construction of a
social problem,” and (b) the rehabilitation industry as its “institutional response” (p. 13). Marta
Russell’s selected writings (Rosenthal & Rosenthal, 2019), produced largely in the 1990s and
early 2000s, offer an explicitly Marxist analysis of the political and economic role of disability in
late 20th century American capitalism. Russell’s analytics include incisive discussions of
capitalism’s necessity of maintaining a reserve of untapped labor, structural inequality related to
housing policy and disaster responses, and the role of incarceration relative to disability in a
capitalist economy, among others. More recently, Paul Longmore’s (2016) posthumously
published Telethons: Spectacle, Disability, and the Business of Charity is perhaps the most
comprehensive example to date of a complex analysis of the inextricably intertwined tendrils of
both cultural politics and political economy—in this case, in the particular example of the
telethon industry.
However, David T. Mitchell and Sharon L. Snyder (2015) have arguably offered the most
innovative theoretical contributions since Albrecht in advancing a complex analysis of disability
and capitalism, or more specifically, of disability and neoliberalism, in their The Biopolitics of
Disability: Neoliberalism, Ablenationalism, and Peripheral Embodiment. In developing the
concept of ablenationalism, Mitchell and Snyder write that “disabled people are increasingly
fashioned as a population that can be put into service on behalf of the nation-state rather than
exclusively positioned as parasitic upon its resources and, therefore, somehow outside of its best
interests” (p. 17). We will return to this notion of disabled people being put into service on
behalf of the nation-state (and more specifically, its economy) as our own analysis develops.
These seminal works collectively offer foundational analyses of the intersections between
capitalism and disability, generally. We are interested here in an analysis of the intersections
between capitalism and autism, specifically. Both Albrecht (1992) and Longmore (2016) offer
analyses of a capitalist political economy of disability that sit in intricate and complex
relationship with incisive analyses of the symbiotic production and performance of the cultural
politics of disability. In developing the analytic heuristic of the AIC, we offer herein an analysis
of the co-constitutive production of both the cultural politics and the political economy of autism
within capitalism. Building upon both Albrecht (1992) and Mitchell and Snyder (2015), we
explore the central and inextricable relationship between ideology and capital under
neoliberalism.
The last 15 years have generated a vast and compelling body of critical scholarship exploring
the cultural meanings of autism and autistic identity through multiple, intersecting,
interdisciplinary lenses. These include feminism, cultural studies, sociology, linguistics,
anthropology, rhetoric, queer studies, and others (e.g., Eyal et al., 2010; Jack, 2014; McGuire,
2016; Murray, 2012; Nadesan, 2005; Osteen, 2010; Rodas, 2018; Runswick-Cole et al., 2016;
Silberman, 2015; Silverman, 2013; Yergeau, 2017). Most of these critical social and cultural
analyses concur with the indisputable claim that autism is now big business—that much has been
obvious for the past several decades. However, relatively little scholarship thus far has involved
any analysis of autism in relation to the structures of our political economy, and none of those
have yet put forth a comprehensive analysis that attempts to integrate critical social and cultural
analyses with and through the overarching lens of political economy. Autistic scholar Michelle
Dawson (2004) may have been the first to pinpoint and name the “autism/ABA industry” (n.p.)
as such, and for the past 15 years, others have continued to describe and critically analyze what
Milton and Moon (2012) call the “vast and exploitative autism industry” (p. 3). Since Dawson’s
first articulation of ABA as an “industry,” Critical Autism Studies (CAS) scholars have
continued to write about the autism industry (Latif, 2016; Milton & Moon, 2012), autism as
commodity (Mallett & Runswick-Cole, 2012, 2016), and autism as commodity fetishism
(Goodley, 2016; Grinker, 2018; Mallett & Runswick-Cole, 2012).
Anne McGuire appears to be the first to have committed to print the term autism industrial
complex, a concept articulated in “Buying Time: The S/Pace of Advocacy and the Cultural
Production of Autism” (2013), itself an incisive analysis of autism and time with/in the social
and economic context of advanced neoliberal capitalism. In the closing paragraph of her analysis
of the ways that autistic experience strains and threatens the boundaries of neoliberal concepts of
time, McGuire notes that “we must take note of how neoliberal versions of advocacy . . . already
represent a ‘good’ and very profitable ‘return’ on an awareness investment” (p. 121). Further, in
pointing to the “sheer breadth of the ‘autism industrial complex,’” she contends that “in one
unbroken—and clearly very lucrative—move, our market-driven times, at once, produce and
regulate, create and constrain conducts that are beyond the norm” (p. 121).
McGuire further develops the idea of the autism industrial complex in her text, War on
Autism (2016), although her discussion of the concept remains primarily descriptive rather than
analytic. McGuire asserts that the “body of the autistic child has generated a multibillion dollar
‘autism industrial complex’—public and private investment interests that benefit economically
from, and indeed whose very fiscal survival is reliant upon, the existence of” autistic bodies (p.
126). Consistent with her stated intent “to provide the reader with a sense of the immensity and
diversity of the autism industry,” (p. 127), McGuire points to the industry of jobs and institutions
whose purpose centers primarily upon autism intervention. She notes that “whole industries have
cropped up around treating and/or curing autism,” while “other industries have discovered it can
also be profitable to take the prevention route,” while still “other industries . . . have honed in on
the autism niche market” (p. 127), including products such as software/apps, toys, books,
communication aids, etc. This commercial diversification is a central and logical outcome of the
rhetorical generativity of the AIC.
Other CAS scholars have subsequently drawn upon this concept in analyzing the economics
of autism (Broderick, 2017; Grinker, 2018, 2020). Grinker (2020) argues that this “particular
diagnosis [autism] became embedded in a financial system that has come to depend on that
diagnosis for its sustainability and growth” (p. 7). Further, building upon Ian Hacking (1999),
Grinker argues that once a diagnostic label—such as autism—becomes a fulcrum around which
institutionalized financial activities coalesce (i.e., once an industrial complex is formed), that
very diagnostic category “provides an incentive for manufacturing people with the diagnosis . . .
whose presence and needs support this financial infrastructure” (p. 9), effectively rearticulating
Mallett and Runswick-Cole’s (2016) contention that autism has been successfully commodified.
Broderick (2017) argues that autism rhetoric (including deployment of the cultural metaphors of
alien, invader, epidemic, enemy, etc.) has been central to that commodification process: the
manufacturing of autism, and thereby, through processes of interpellation, autistic people—all in
the service of manufacturing a broader cultural narrative or logic of intervention, thus producing
the market for, and teleologically justifying and sustaining the profit-generating infrastructure of,
the autism intervention industry.
Two edited collections published over the past decade have worked to establish the
foundations and contours of the emergent field of CAS, and each of these has engaged somewhat
with questions of political economy, but to a limited extent. The first, Worlds of Autism: Across
the Spectrum of Neurological Difference (Davidson & Orsini, 2013), actually coined the term
critical autism studies and developed a loose conceptual framework of what CAS comprise.
These include: (a) careful attention to the ways that power shapes our understandings and study
of autism, (b) the advancing of empowering cultural narratives about autism, and (c) a
“commitment to develop new analytical frameworks using inclusive and nonreductive
methodological and theoretical approaches to study the nature and culture of autism” (Orsini &
Davidson, 2013, p. 12). Thus, the import of studying narrative, culture, and specifically, power is
placed front and center in this articulation of the aims of CAS as a field of critical scholarship,
although economics is not explicitly invoked.
 Nevertheless, as economics is a central mechanism through which power circulates, within
this edited collection a couple of manuscripts do engage with the economics of autism, albeit in
limited ways. For example, Nadesan (2013) presents an analysis titled “Autism and Genetics:
Profit, Risk, and Bare Life.” Nadesan, whose earlier (2005) comprehensive sociocultural analysis
of autism as a construct appeared to spark the wave of critical scholarship on autism that has
been produced over the past 15 years, writes in this piece specifically of the social and political
processes of assessing and managing the “economic risks” (p. 117) associated with autism.
Through an analysis of the prioritization of funding related to autism (including allocations of
public funds toward research, pharmaceuticals, and the quest for genetic markers that may yield
either pre- or postnatal tests for autism), Nadesan raises difficult questions about the ratio of
public dollars spent on care and support versus basic research ultimately aimed at prevention of
autism. In the context of neoliberal austerity measures, Nadesan warns that “Family members of
people with autism will be ‘responsibilized’ for their care without the benefits of supports as
states, counties, cities, and school districts shed services” (p. 134). Additionally, Nadesan
somewhat ominously predicts that the prioritization and investment of funding in autism
susceptibility testing may “have the potential of refiguring risk so that parents of autistic children
are made financially responsible for the ‘choice’ to keep (that is, not abort) their autistic
children” (p. 134), and that “this prioritization could undermine support for costly educational
and therapeutic supports” (p. 137). In this same volume, Bumiller (2013) critically analyzes the
politics and economics of the increasing privatization of responsibilities of care in a neoliberal
economy, arguing that “it is necessary to reimagine the [financial] responsibilities of the state in
the hope of creating a more socially inclusive future for people with autism” (p. 145). Both of
these forays into the political economy of autism fundamentally circulate around the costs of
intervention, care, and support, and whether those costs should be socialized or privatized, rather
than critically examining the intervention industry itself.
In a second edited collection (Runswick-Cole et al., 2016) aiming to contribute to the nascent
field of CAS, only a few pieces refer—and most of those somewhat tangentially—to the import
of economics in the critical study of autism. In the introductory chapter, Runswick-Cole (2016)
asserts the problematic nature of the commodification of autism (see also Mallett & Runswick-
Cole, 2012, 2016): “This thing called autism is everywhere” (p. 25, emphasis in original). She
further acknowledges that “Clearly, there is money to be made in autism” and cogently, that “it is
not possible to comment on the autism industry without contributing to it” (p. 26). Nevertheless,
few of the manuscripts in the collection explicitly analyze this autism industry, although a
number concede its profit-generating existence as taken-for-granted background of their
analyses. For example, Goodley (2016) refers briefly to multiple forms of “commodity fetishism
around autism” (p. 156), and McGuire (2016) parenthetically notes that “the notion of spectrum
offers a hopeful (which, from the vantage point of capitalism, most often means lucrative)
narrative of the possibility for an incremental recovery of normative life” (p. 103). Further,
Timimi and McCabe (2016) rather obliquely, and almost as an aside, quip that “To us, however
it seems that the people who have most obviously benefitted from the increase in the use of tools
for screening for and diagnosing of ASDs have been the professionals themselves” (p. 173).
Latif (2016) engages with these issues somewhat more explicitly. Although his analysis is
largely centered on ethical deliberations around autism diagnoses, that discussion is squarely
framed within the context of neoliberal austerity policies as a sort of backdrop for the ethical
analysis. Latif principally aims to explore how people’s ideas about autism “are modified and
influenced by the dominant classification systems, which in a capitalist market has been driving
toward a technically based biomedical model of mental wellbeing” (p. 288). Latif further notes
that “whilst such a model may be good for expanding markets, problems of feeding
disproportionate demand against limited resources arise in universal public health systems such
as the United Kingdom National Health Service (NHS)” (p. 288). This primary concern with
scarcity of resources in general, and with the impacts of neoliberal economic policies of
privatization and austerity in particular, align Latif’s, and most of the analyses of economics in
this volume, with those in the Davidson and Orsini (2013) collection.
Mallett and Runswick-Cole (2016) offer the only contribution to this volume to explicitly
advance an analysis of autism within capitalism in their piece “The Commodification of Autism:
What’s at Stake?” wherein they argue that “autism has become a commodity; it is produced,
exchanged, traded and consumed” (p. 110). These authors contend “it is the moment when it
[autism] becomes a ‘thing’ that it becomes consumable and, therefore, amenable to
commodification” (p. 117). They successfully argue and amply demonstrate in this piece that
autism has become a hot commodity, illustrated with cogent examples of autism therapies,
entertainment, and popular culture, and even the rebranding efforts of the neurodiversity
movement. However, neither Mallett and Runswick-Cole (2016) nor any other extant analyses
yet demonstrates how autism came to be successfully commodified, nor the nature of the
intersecting social, historical, cultural, political, and economic infrastructures that both produce
and sustain it as a lucrative commodity.
Multiple authors have offered useful descriptions of the nature and range of the profit-
generating marketplaces operating in the AIC—e.g., not only intervention services, but
diagnostic and evaluation services, scholarship and research industries, media industries, the
special education and related services industries, niche technology industries, etc. (e.g., Grinker,
2020; Mallett & Runswick-Cole, 2016; McGuire, 2013, 2016). Almost all extant analyses of
autism and neoliberal capitalism focus on the societal and personal implications of privatization
and austerity, vis-à-vis access to intervention products and services. Or as Grinker (2020) puts it,
exploring the challenges parents face “as they seek to find services and social supports that will
enable their diagnosed children to be educated and launched into the neurotypical world” (p. 8).
However, to date, no one has yet developed a comprehensive conceptual analytic of the cultural
and historical contexts in which the AIC emerged, nor how the AIC operates in the overlapping
spheres of both cultural politics and political economy, manufacturing not only the commodity
of autism itself, but also, and crucially, the cultural logic of intervention that undergirds the
entirety of the AIC’s ideological and economic infrastructure. This analysis aims to do just that.
We develop and deploy the AIC as a useful heuristic device that enables us to document and
critically analyze the intersecting spheres of both cultural politics and political economy in the
simultaneous cultural and economic production of autism and the cultural logics of intervention
and later prevention in relation to it. Our analysis aims to hearken back to Albrecht’s (1992) in
that we aim to braid together a complex analysis of (a) the production of autism as a “social
problem” with (b) the institutional (interventionist, preventionist) response to that “problem.”
That is, we explore the ways in which the cultural politics of autism and the economy of autism
co-constitute one another. In so doing, we draw upon and weave together analyses of the
intersecting strands of ideology, rhetoric, and discourse, together with the interlocking strands of
social policy, business, education, and medicine, all of which collectively serve to generate and
to justify further extraction of profit from autism—and therefore autistic people— in an
advanced neoliberal capitalist economy.
 AIC Conceptualized

Since Eisenhower first burned the concept of the military industrial complex into the public
imagination in his now-iconic warning in 1961, the notion has been extrapolated to many
different spheres of culture, society, and government. No matter the context, these extrapolations
implicitly evoke Eisenhower’s urgent claims: that “we must guard against” the potential for the
“disastrous rise of misplaced power,” forever latent (if not actualized) in association with
entrenched profiteering and ideological monopoly (Eisenhower, cited in Picciano & Spring,
2012, p. 1). We’ll briefly index here two extant extrapolations of this concept relevant to our
development of the heuristic of the AIC: (a) the medical industrial complex (Ehrenreich &
Ehrenreich, 1970; Mingus, 2015), and (b) the education industrial complex (Picciano & Spring,
2012).
An early and obvious extrapolation of the idea of the military industrial complex was the
articulation of the analogous medical industrial complex (Ehrenreich & Ehrenreich, 1970), more
recently further conceptually developed by Mia Mingus (2015). Mingus proposes a fluid and
dynamic four-pronged interlocking web of sectors, comprising the sectors of science and
medicine, health, access, and safety, further articulating corresponding and underlying
motivations or drivers of these sectors: eugenics, desirability, charity and ableism, and
population control. Within these overlapping sectors, and driven by these overlapping cultural
ideologies, values, or motivators, Mingus articulates some of the major profit-generating
components of the medical industrial complex, such as the pharmaceutical and mental health
industries, medical schools, insurance companies, and the prison-industrial complex and nursing
home industries. Mingus’s conceptual framework is at once complex and dynamic, and
indicative of a rapidly evolving marketplace in relation to a relatively stable underlying
economic and ideological architecture.
Another obvious extrapolation from the concept of the military industrial complex is that of
the education industrial complex: Picciano and Spring (2012) outline a thesis detailing the rise of
what they call “the great American education-industrial complex,” defining it as

networks of ideological, technophile, and for-profit entities that seek to promote their beliefs, ideas, products, and services
in furtherance of their own goals and objectives. This complex is fueled by significant resources and advocacy provided
by companies, foundations, and the media that want to shape American education policy to conform to their own ideals
and that also stand to profit significantly from its development. (p. 2)

Substitute “autism” for “education” in this definition and you have a cogent description of the
AIC. Picciano and Spring’s analytic is a much simpler heuristic than Mingus’s, comprising
principally the tripartite intersecting components of ideology, technology, and profit. Central to
Picciano and Spring’s heuristic is the intersections of networks of entities that seek not only to
promote their products and services in order to generate profit, but that simultaneously seek to
promote their ideas and beliefs (which is just as central to the ultimate goal of generating profit).
Autism as commodity is produced and consumed in part through the mobilization of both the
medical and education industrial complexes, and the specific exploration of the AIC has the
potential to further explicate and illuminate how both underlying industrial complexes function.
Without endeavoring to reconcile or collapse these two divergent conceptual frameworks into
one, we will nevertheless note that in the case of the AIC, multiple intersecting and networked
sectors of the economy are implicated in the simultaneous production not only of technologies
(products and services), but also of ideologies (concepts, values, beliefs, and cultural narratives),
that are jointly marketed, produced, and distributed for consumption, all in the ultimate service
of profit generation.
Indeed, Picciano and Spring (2012) point out the centrality of these networks to the economic
operation of the educational industrial complex, noting that it

is not simply a single entity conspiring to influence education policy. In fact, it is made up of multiple networks that
sometimes share agendas but frequently operate independently and compete with one another for contracts and sales of
goods and services. (p. 2)

As is the case with both the medical and educational industrial complexes, these networks of
entities that comprise the AIC are loose and overlapping, and in many ways have emerged over
decades as an ad hoc apparatus that is distinctly different from a planned, coordinated,
orchestrated monolithic entity. We offer here an abridged composite narrative of the emergence
of several main networks of “players” on the autism scene, coupled with brief illustrations of
their emergence further solidifying the foundations of AIC as described.
Among these overlapping and intersecting authorities operating in the AIC marketplace are at
least four different networks of players, each of which is intimately connected with the field of
behaviorism, generally, and with the field of applied behavior analysis (ABA), more specifically.
These include: (a) academic behaviorists (PhDs in behavioral psychology, teaching at institutions
of higher education and publishing studies and position papers in peer-reviewed scientific
journals); (b) nonautistic parents of autistic children; (c) the Behavior Analyst Certification
Board (BACB) (a private, nonprofit corporation established in 1998 that certifies behavior
analysts at multiple levels); and (d) Autism Speaks (self-described as the world’s largest
scientific and advocacy organization for autism; described here as a global, multiplatform,
neoliberal media organization and corporate-style policy lobbyist). These players anchor a
network of interrelated ventures, and together comprise the foundational plutocrats of the AIC,
each of which currently participates in some way in the commodification of autism, as well as
the concurrent manufacture and branding of its market through producing interventionist and
preventionist logics for public consumption. In so doing, each of these component networks also
participates in the commodification of autistic bodies and the production of autistic identities.
As Eisenhower warned, at any time that power is consolidated in the hands of a few, we must
guard against its potential abuse. Eisenhower saw inherent danger and hidden costs in the
tempting profitability of the military industrial complex—he feared that the industry would be
driven not by the interests of national security, but rather by the interests of private and corporate
profitability. He also feared that the human costs of military proliferation would be regarded as
insignificant in the face of its profitability. Likewise, we fear (and assert) that the AIC is driven
not by the interests of autistic individuals but by the interests of those who stand to profit from
the AIC. Additionally, we contend that the costs to autistic people of the proliferation of the AIC
have generally been regarded, thus far, as insignificant in the face of its profitability.
Eisenhower specifically warned of the dangers of our national military functioning as a
profit-generating sector of the economy, foreseeing the vast potentials for corruption,
consolidation of power, and above all, profit superseding national security as the central driver of
decision-making. Arguably, the rise of the military-industrial complex was an inevitable
development in late 20th century American capitalism. So too, was the subsequent consumption
of the economic sectors of health care (by the health insurance and pharmaceutical industries),
education (by the textbook publishing and testing industries), and public safety and criminal
justice (by the prison industry), among myriad other sectors of our economy that arguably should
never be driven by the extraction of corporate or private profit. Most of the early descriptions of
the AIC largely focus on documenting the actual profit-generating infrastructure (e.g., the sale of
intervention services, products, etc.) as the presumed architecture of the AIC. We contend that
those products (whether they be goods or services) that are literally being bought and sold—
through financial transactions that are generative of profit—are actually epiphenomenal features
of the AIC, and are better described as components of the autism industry. They better enable us
to perceive the existence of the AIC, and they are, in effect, suspended by its structures, but they
do not in themselves comprise the AIC, nor do they constitute its most salient or foundational
products.
We concur with Mallett and Runswick-Cole’s (2016) assertion that autism has been
successfully commodified, and we argue that the first central ideological product manufactured
and consumed in the AIC is the commodity of autism itself. However, although Mallett and
Runswick-Cole (2012, 2016) center much of their discussion on autism knowledge as
commodity, we are compelled to reiterate that autism does not merely exist as an idea in a
disembodied epistemological state, being bought, sold, exchanged, and consumed in an abstract
market. Rather, autism is a construct inscribed upon, experienced through, and materialized by
the bodies of autistic people, and we concur with McGuire’s (2016) assertion that the
multibillion-dollar AIC generates industries “that benefit from, and indeed whose very fiscal
survival is reliant upon, the existence of” not merely autism as a concept, but autistic bodies (p.
126, emphasis ours). Thus, it is not merely autism as a concept that has been commodified, but
more perniciously, the very bodies of autistic people.
While neoliberal capitalism without question undergirds the entirety of the AIC, a more
specific ideology also drives the particular historical circumstances of its emergence and
development, one that (unlike capitalism generally) has its very own proprietary technology: the
ideology of operant behavioral psychology and its associated technologies of applied behavior
analysis (ABA). It has been the deployment of behaviorism as an ideology—driven through its
applied technologies of ABA—that has enabled the development of a large-scale and complex
technocratic infrastructure for generating profit from autism over the course of the last 75 years.
And the specific ideology of operant behaviorism, added to the ideology of neoliberalism, has
profoundly shaped the second central ideological product manufactured and consumed in the
AIC: the cultural logic of (behavioral) intervention.
This analysis attempts to excavate the particularities of the historical entanglements among
autism, operant behaviorism, and capitalism as they emerged in the mid-late 20th century and
persist today. We argue that behaviorism happened to be implicated in the foundational
structures of the apparatus of the AIC because of serendipitous historical circumstances wherein
behaviorism was contemporaneously ascendant with the ascent of autism as an ontological
category, and with the rapid development and ascendance of global neoliberal capitalism
generally. However, the role of behaviorism could just as easily have been played by Freudian
psychology (a decade or two earlier) or brain-based neuroscience (a few decades later). The
heuristic of the AIC enables us to critically examine the ways that ideology and cultural politics
fluidly and dynamically evolve as capitalism evolves, and we must understand both in relation to
each other and to autism as a historically specific ontological category. The work of the
industrial complex consists in imbuing the ontological category of autism with particular cultural
meanings and significances, and in further transforming that ontological category into a
successful commodity through a range of manufacturing, salvaging, extraction, and branding
efforts. In addition to producing autism (and therefore, autistic people) as commodities, the
industrial complex also manufactures its own market and consumers through producing for mass
consumption the need for, consent to, and legitimacy of the ideological product of the cultural
logic of intervention (and later, of prevention—see Chapter Eight). The central “problem,” from
this perspective (if pressed to identify just one) is less behaviorism than it is capitalism.

What Are They Selling You? Autism Within Capitalism

Wang (2018), in an incisive analysis of the debt economy in her seminal text Carceral
Capitalism, asks, when predatory lenders are targeting consumers for “opportunities” to open
lines of credit and consume other forms of product derived from the commodity of debt, “what
are they selling you?” (p. 32). Financial institutions engaged in these practices, she argues, “are
selling you indebtedness itself” (p. 33, emphasis in original). We expand McGuire’s initial
conceptualization of the AIC by asking the simple question, when the AIC is manufacturing its
products for consumption, “what are they selling you?” Yes, intervention services are being
produced and consumed. For the most part, they are being produced by professions and
occupations that didn’t exist a century ago—behavior therapists, speech and language therapists,
occupational therapists, special educators and paraeducators, play therapists, legal firms
specializing in autism-related litigation, etc. And they are being consumed mostly by the
nonautistic parents of autistic children procuring those services for their children and the public
school districts charged with educating those children. In the autism economy, the individual
products being bought and sold—the therapies, the books, the “awareness” T-shirts, the fidget
spinners, the evaluations, the myriad interventions and services—constitute the autism industry.
But a vast deal more than these products is being consumed in the AIC. What else are they
selling us? In addition to (and arguably obscured by) these epiphenomenal products and services
that are literally being bought and sold to the tune of billions of dollars annually in the AIC, we
contend that the central products that the autism economy is producing and marketing for public
consumption—in effect, “is selling you”—are (a) autism itself (and therefore autistic people) as a
“social problem” (Albrecht, 1992), and its integrally intertwined, complementary constituent
product, the “institutional response” (Albrecht, 1992) of (b) the cultural logic of intervention.
A crucial analytic framework that we bring to bear upon our analysis of the AIC stems from
Wang’s critical analysis of carceral capitalism—specifically, her conceptual expansion of Marx’s
notion of the lumpenproletariat. In Carceral Capitalism, Wang describes the political economy
of the prison system. She draws on Marxist political theorist Rosa Luxemburg to describe how
capitalist accumulation adapts to changing forms of capitalist production and consumption. In
her expansion of Marx, Wang argues that Marx assumes that the proletariat are incorporated into
the capitalist system as waged laborers. However, due to rapid technological advancement in
production, this is no longer so and “segments of the workforce are also regularly shunted from
the process of production.” (p.109). Wang contends that “This process continually opens up new
domains for expropriation and value generation, whether it is through money lending or
warehousing people in prisons” (p. 109). Debt, she argues, is a means for those dispossessed of
wage labor to consume, what Marxist geographer David Harvey (2003) terms “accumulation by
dispossession” (p. 154). She describes Marx’s lumpen class—the unemployed—as having a dual
function. The first function—Marx’s conceptualization—is to create a class that is available to
work, workers without work, that functions as a labor reserve that drives down wages and
prevents unionization. Wang builds on Marx’s analysis to articulate a second function of the
lumpen class. Wang argues that lumpenproletariat are also integrated into the consumer class
(usually reserved for wage laborers) by the acquisition of debt and consumption vis-à-vis
borrowed money.
 We contend that the AIC is another mechanism by which the lumpen class (the unemployed)
are integrated into consumption. Disabled people are underemployed (Persons with a Disability,
2020) and, depending on the nature of one’s disability, may not enter into the economy as a wage
laborer. However, much like the acquisition of consumer debt, autistic individuals are
constructed as possessing a born indebtedness through the rhetoric of the AIC producing autism
as a social problem. The debt here is educational, therapeutic. And estimates abound as to the
cost of this educational and therapeutic debt. Grinker (2020) notes that

Buescher et al. (2014) estimate that for the United Kingdom, the average lifetime cost of care for a person with autism is
$1.4 million; Leigh and Du (2015) estimate that by the year 2025 the total national cost in the United States for caring for
people with autism will exceed $461 billion per year. (p. 7)

But this is when autism goes to work. Grinker (2018) notes that, “Paradoxically, autism is at
once a threat to economic growth and (at least for many parts of American society) an engine of
economic growth” (p. 244). We contend that it is not truly paradoxical. The former narrative (the
high “cost” of autism) serves a necessary role in shoring up the justification for the extraction of
profit from the autism industry (thus, this apparent “paradox,” we argue, is but two sides of the
neoliberal coin).
Mitchell and Snyder (2015) argue that in a neoliberal political economy, “disability has been
transformed into a target of neoliberal intervention strategies” (p. 205). Further, they argue that,
“[r]ather than a former era’s economic ‘burden,’ disabled people have become objects of care in
which enormous sectors of postcapitalist service economies are invested” (p. 205). And although
Mitchell and Snyder posit that the notion of “burden” belongs to a former economic era, we
argue that, rhetorically, the presentation of autistic people as potential future economic burdens
continues to be trotted out as a justification for participation in and consent to the intervention
industry (in which a fair amount of profit is systematically extracted from autistic people). The
net amount of therapy needed to bridge the gap to wage laborer/consumer becomes a means of
consumption, thus integrating the lumpen class of disposed and dispossessed autistic citizens into
the realm of consumption as consumers of intervention, the “institutional response” to the
“problem” of autism as commodified. Or, as Mitchell and Snyder contend, the economic
relations of ablenationalism situate disabled (in this case autistic) bodies “in a position
tantamount to un(der)explored geographies: they come to be recognized as formerly neglected
sites now available for new opportunities of market extraction that fuels so much of the
production end of neoliberal capitalism” (p. 206).
And unlike Marx’s original concept of the lumpen class, in the case of autistic people, it is
not merely those of age to be potential (albeit “failed”) wage earners that are targeted through
these extraction mechanisms. Rather, through the processes of dispossession, children as young
as 2 years of age are economically mobilized as raw material to be extracted and capitalized
upon, even as their parents and schools are integrated as consumers of intervention, enacted upon
the bodies of their autistic children. We argue here that the massive scaling up of the scope of the
AIC is in no small part dependent upon the successful braiding together of the cultural political
and economic architecture such that nonautistic adults (primarily parents of autistic children,
teachers, and school administrators, etc.) were groomed as the AIC’s targeted consumers of
autism as a social problem (and therefore, its complex of interventions). This circumstance has
engendered not merely the commodification and consumption of the idea or the concept of
autism, but more perniciously, the commodification and consumption of autistic bodies,
including the bodies of very young children, in the generation of profit for these intervention
industries.
Essentially, we argue that the AIC is not an anomaly, an aberration, or a corruption of the
meanings or materialities that autism “should” have; indeed, we argue that within late 20th
century American neoliberal capitalism, the AIC couldn’t not have developed. It might have
developed slightly differently if specific historical and cultural circumstances had unfolded
slightly differently (20 years earlier, its foundational disciplinary foil may have been Freudian
psychology; 20 years later, it may have been brain-based neuroscience), but essentially, within
neoliberal capitalism, there had to develop, and will undoubtedly continue to be, an AIC. We
have been heartened and intellectually nourished by the last decade and a half of critical autism
scholarship (e.g., anthropological, sociological, literary, rhetorical, feminist, queer, etc.),
including the birth of a subfield of academic inquiry dedicated to it (CAS). However, we simply
cannot proceed further with our own critical scholarship on autism without a systematic and
comprehensive exploration of the intersections of neoliberal capitalism and autism, and the ways
that the former has been constitutive of the latter (virtually from its conception).

What Are They Selling You? The Cultural Logic of Intervention

The AIC couldn’t thrive as it has if it merely produced the commodity of autism; it also
manufactures normative and narrative cultural logics in relation to the “problem” of autism—the
cultural logic of intervention (and later, of prevention). Thus, encompassed within the production
of autism for public consumption is the simultaneous manufacture for consumption of the
constituent rhetorical products of (a) both the need for and consent to intervention for autism and
(b) claims to the legitimacy of particular intervention technologies. These constituent rhetorical
products work in tandem with the production of autism as commodity to produce for widespread
consumption the narrative logic that not only is autism dangerous, threatening, and generally
bad, but also that it therefore necessitates intervention and that certain forms of intervention are
more legitimate (and better investments) than others.
The cultural logic that produces both need for and consent to intervention for autism is
manufactured through the systematic deployment and manipulation of both cultural fears and
cultural hopes, in crafting hegemonic cultural narratives that autism (of course) necessitates
intervention. The primary mechanism creating this market for the industrial complex of
interventions is currently a wide-ranging, sophisticated, multiplatform, ubiquitous, and global
media campaign—you name it: social media, television, magazines, newspapers, television talk
shows, talk radio, public service announcements, celebrity-sponsored fundraising concerts and
other events, government and policy documents and rhetoric, etc. However, the foundational
labor of producing this market began with academic behaviorists and later included nonautistic
parent advocates before being scaled up to include global media campaigns and the ABA
intervention services industry itself. We’ll additionally note that this media campaign—and its
earlier waves of academic and parental advocacy—integrally comprises a strong sense of cultural
urgency (e.g., autism is a “emergency,” it’s an “epidemic,” it’s a “tsunami,” etc.) in its
establishment of need, thereby simultaneously facilitating and streamlining widespread consent
to participation in the intervention industry. And from the very inception of what can only be
understood as a large-scale marketing and branding campaign, the rhetorics of both hope and of
fear have been systematically deployed in purposeful, effective, and largely successful ways
(Broderick, 2009, 2010, 2011).
The AIC also systematically manufactures, within the cultural logic of intervention, narrative
claims to its own legitimacy (both “scientific” legitimacy through the strategic deployment of
scientism as rhetoric, as well as “professional” legitimacy, established through the
professionalizing discourses and centralized certification infrastructures of the BACB). The
rhetoric of positivist science has been absolutely central to the AIC’s branding campaign from
the beginning, serving as a foundational argument for ABA’s monopolizing of the economic
architecture to follow. Subsequent to the emergence of that economic architecture, in many ways
the profit-generating apparatus itself has served as a further, teleological constitution of
legitimacy: We offer intervention products and technologies, we recognize only our own
intervention products and technologies as “evidence-based,” we have ensured through policy
lobbying that funds will flow toward our intervention services, granting us dominant market
share if not monopoly status; therefore, we also have market legitimacy. Through the intertwined
architectural arms of scholarship, policy, and popular culture/media, both the privatization of
intervention industries and the simultaneous corporate-style globalization of “advocacy” and
philanthropy emerge as monolithic, politically “neutral,” “legitimate”—and importantly—profit-
generating establishments.

What Are They Selling You? Autistic Identity

A final, symbiotic rhetorical and material product of the AIC that simply cannot be separated
from the AIC’s production of the commodity of autism as social problem and its corollary
interventionist logic is the production of the very identities of autistic people. The AIC itself is
parasitic upon the bodies of autistic people; it cannot exist without autistic people, who are often
exploited as unwitting or unwilling raw material for profit extraction in the industrial complex,
particularly when those bodies are the bodies of very young autistic children. Through
biopolitical technologies of control and virtually propagandist monopolies of ideas, the AIC
actively constitutes what it means/is to be autistic within global neoliberal capitalism. It is
important to note that this third constituent product of the AIC is integrally intertwined and
performed with/in each of the first two. Indeed, we argue that one can’t engage in the production
of any one of these three without effectively engaging in the production of the other two. For
example, in the manufacturing of need for the AIC, and thereby the grooming of consent to it,
identities are simultaneously being forged through powerful processes that transform and
interpellate individual subjectivities.
Within the cultural politics and political economy of the AIC, autistic people are
manufactured as autistic identities are interpellated through specific cultural and media
representations and productions of autism, coupled with biopolitical technologies of surveillance
and control. Similarly, when the AIC is rhetorically manufacturing the need for its own
economic architecture (intervention products, technologies, services, etc.) through the
propagation for popular cultural consumption of heinous ideological metaphors about autism as
enemy, predator, alien, epidemic, tsunami, caravan, etc. (insert dangerous and urgent metaphor
of the month here), identities are simultaneously being marketed for consumption. Autistic
people are integrated into consumption through their function as the lumpenproletariat class that
forms the economic raw materials of the intervention industry. What are they selling you? A
cynical, bigoted, culturally devalued notion of autism itself, and therefore, of being autistic. A
significant difference in this instance is that autistic people are not the primary consumers
targeted in the AIC marketplace—nonautistic people (both parents and potential parents of
autistic children) are. Autistic people, rather, are the commodities of the AIC.
This analysis represents a significant departure from other critical autism scholars’ analyses
of autism within capitalism, many of which appear to accept the naturalness of the intervention
industry itself and most of which primarily situate their critiques within neoliberal austerity
policies and concerns about scarcity of intervention resources. For example, Mallett and
Runswick-Cole (2016) warn us of the potential of autism to be made “useless” and to be subject
to the whims of the market, with the loss of support services being collateral damage. We
contend that the AIC is actually itself abundantly generative, not an arbitrary vessel for surplus
value; rather that the AIC both produces and consumes through constructing autistic people as
fundamentally, infinitely indebted. Together, the AIC’s production and commodification of both
autism as an inherently problematic ontological category and the cultural logic of intervention in
relation to it have been structuring our ideas and conceptualizations about autism, our access to
dissenting information about autism, and effectively limiting the range of our responses to autism
through flooding the marketplace of ideas with the monopoly of intervention in general and ABA
intervention in particular, for more than 75 years.

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CHAPTER TWO

Consuming Autism as Social Problem and the

Cultural Logic of Intervention
ALICIA A. BRODERICK AND ROBIN ROSCIGNO

I T IS SOMEWHAT FASHIONABLE among left-leaning academics (or those who fancy themselves to
be leftist, most of whom are squarely—or barely—left-of-center liberal progressives) in the
fields of disability, autism, and education scholarship to demonize behaviorism (and
behaviorists) as some sort of strawman or symbolic effigy upon which we can blame all of the
ills, inequities, and oppression experienced by disabled and/or autistic people in schools and in
society. However, as we argue in the opening chapter, even if behaviorism were somehow
removed from the mix, autism and capitalism remain. Thus, we argue, within capitalism—more
specifically, within advanced global neoliberal capitalism as it evolved over the second half of
the 20th century in the United States—autism couldn’t not have been commodified. The central
problem is less behaviorism than it is capitalism. Nevertheless, because behaviorism was the
instrumental vehicle of that commodification of autism within the specific historical, cultural,
and economic circumstances of the mid-late 20th century, we begin with an analysis of the
pivotal role that behaviorism played, within capitalism, in commodifying both autism and autism
intervention, and therefore, in laying the foundations of the industrial complex.
But why behaviorism, specifically? It serendipitously happened to be in the right place at the
right time, historically, to be sure; and autism was certainly ripe for commodification. However,
in the spirit of giving credit where credit is due, we argue additionally that behaviorism proved to
be such a generative vehicle for building the early foundations of the industrial complex
precisely because behaviorism was already offering a key ideological product as integral to its
brand (that few others had on offer at that time), which facilitated and hastened the
commodification process: Behaviorism was packaging and selling hope. And hope always has a
market. Therefore, if we want to understand the early development and later institutionalization
of the ideological apparatus of the AIC, it would be a mistake not to acknowledge the significant
role played by the cultural need for hope that emerged in relation to autism as an ontological
category, and the success with which behaviorism appeared on the scene in the mid-1960s to
meet that need. It was behaviorism’s keen perception of that cultural need for hope—and its
ability and willingness to craft and brand its own products in relation to it—that precipitated the
initial commodification of autism, and importantly, that neatly packaged the cultural logic of
intervention along with it in a 2-for-1 deal.
In the mid-20th century, autistic counternarratives (Broderick & Ne’eman, 2008) had not yet
emerged, and the dominant narratives about autism that were circulating at that time were being
told by professionals in various fiefdoms within psychology (e.g., Freudian, developmental,
behavioral), and by nonautistic parents of autistic children. Because this exclusively etic
perspective did not include the experiences and agendas of autistic people, it is perhaps not
surprising that the particular brand of hope on offer was a quintessentially ableist one, which at
its very core ontologically and inextricably linked autism as “disease” and “disorder” with a
cultural logic and narrative of intervention and, eventually, of prevention. Indeed we must also
articulate that this ableist vision of hope that was on offer (to return to Wang’s [2018] incisive
question, “What are they selling you?”) was therefore, also, at its core, eugenic—one that sought
as its ultimate aim the erosion, if not the future eradication, of the ontological category of autism
itself (and therefore, of autistic people).
Nevertheless, late 20th century and early 21st century American behaviorists have proved
themselves to be masterful rhetoricians, branding and marketing experts, and ultimately,
businesspeople. This chapter examines behaviorism’s foundational role in manufacturing autism
as a social problem: specifically, its effective use of the ideological and rhetorical tactic of
deploying hope in the mutual constitution of both autism as an ontological category, and its
ontological corollary, the cultural logic of (behavioral) intervention in relation to it. Thus, we
argue that capitalizing upon autism (and therefore, upon autistic people) was effectively baked
into the behaviorist cake from the mid-20th century onward.

Product #1: Autism as Social Problem (1943/44–1965)

Behaviorism, and by extension ABA, is intimately connected with the increased visibility of and
attention to autism in the United States. At this point in time, ABA continues to be the only
therapy for children with autism that is funded by most health insurance policies, and is well-
established in public education for autistic students (Keenan et al., 2015). Many teacher-
preparation programs offer and encourage their special education students to pursue a certificate
in ABA, and the rate of certification for BCBAs increases exponentially every year (Behavior
Analyst Certification Board, Inc.®, n.d.). Indeed, the BACB reports on its own website that,
according to a 2016 practice-area job survey of their own certificants, 67.65% of respondents
report working in the “autism” sector of the economy, with the next largest response (12.24%)
reporting working in the “education” sector of the economy. (N.B. We note that these are neither
mutually exclusive nor parallel categories, and also that these two are the only response
categories that logged double-digit percentage responses).
Behaviorism as an applied science (not unlike autism as a concept) is relatively new. The
environmental manipulation of behavior vis-à-vis operant conditioning is B. F. Skinner’s
creation, developed in the mid-20th century, and public and private schools in the United States
adopted behaviorism almost immediately as it offered ready technologies for controlling
children’s behavior (Barrish et al., 1969). While alternative approaches (i.e., responsive
classrooms, trauma-centered classrooms, etc.) have, in the intervening years, replaced some
traditional behavioral strategies in many general education classrooms, ABA retains a firm and
growing hold on the “treatment” and “education” of autistic students, specifically. Radical
behaviorism has been largely and long abandoned in the learning sciences (Chomsky, 1959), and
its distinguishing features have become outdated, especially with the advent of neuroimaging
technologies (Canli & Amin, 2002). At the time he was articulating a theory of radical
behaviorism, Skinner himself conceded that the study of behavior only through the observable
was both necessitated and limited by the inability of the scientist to observe internal processes
(Skinner, 1974, pp. 16–17). With the advent of neuroimaging and the ability to observe internal
states and processes, behaviorism’s sole claim to scientific legitimacy on the terms of logical
positivism is now outdated. However, the tightly intertwined relationship between ABA and
autism remains unscathed. How did this enduring relationship come to be? How did behaviorism
atrophy in so many other regards but live on and indeed thrive in this particular instance? In
order to better understand the generative and ultimately lucrative business opportunity that
autism presented to behaviorism, we must first briefly recount the emergence of autism as an
ontological category in the mid-1940s.

The Emergence of Autism as Ontological Category

In 1943, Leo Kanner, writing at Johns Hopkins University in Baltimore, Maryland, published an
article reporting on case studies of 11 children, all of whom appeared to share a number of
common characteristics that he suggested formed a “unique ‘syndrome’ not heretofore reported”
(p. 242). He titled the article, “Autistic Disturbances of Affective Contact” (1943), and
characterized the children as possessing, from the very beginning of life, what he called an
“extreme autistic aloneness” (p. 242). The following year, Hans Asperger, writing in Austria,
published in German an article called, “‘Autistic Psychopathy’ in Childhood” (1944/1991). This
article also presented case studies of several children that he described as examples of “a
particularly interesting and highly recognisable type of child” (p. 76). Both Kanner and Asperger
independently applied the term, autism and, alternately, autistic (originally coined by Swiss
psychiatrist Eugen Bleuler in 1911 in reference to the aloneness experienced by schizophrenic
patients, from the Greek, meaning “of oneself”) to the children they observed and described.
Thus, in the United States and in Europe, in 1943 and 1944 respectively, “autistic disturbances”
and “autistic psychopathy” became more than adjectives, more than mere descriptors of
particular experiences or actions. “Autism” itself became a syndrome, a construct, a noun, a
thing: an ontological category.
The cultural history of the emergence and reification of autism as an ontological category
(and specifically, as a psychological and/or biological diagnosis) is complex, nuanced, and
deeply embedded in geopolitics—a history in itself worthy of book-length exploration and detail.
This is not that book; however, the reader is directed to Edith Sheffer’s (2018) comprehensive
and meticulously documented history of the emergence of “autism” and subsequently,
“Asperger’s Syndrome,” in Vienna under the occupation of the Third Reich. Recall that Mitchell
and Snyder (2015), in their development of the concept of ablenationalism, described
circumstances in which “disabled people are increasingly fashioned as a population that can be
put into service on behalf of the nation-state rather than exclusively positioned as parasitic upon
its resources and, therefore, somehow outside of its best interests” (p. 17). Sheffer’s history of
the emergence of autism as a diagnostic category in Nazi Vienna illustrates in exquisite and
chilling detail the sociopolitical process of the actual creation or constitution of disabled (in this
case, autistic) people being “put into service on behalf of the nation-state.” Indeed Sheffer
describes the Third Reich as a “diagnosis regime” (p. 13), and the very diagnostic processes that
marked some as debilitated (Puar, 2017), and therefore “parasitic upon its resources” (Mitchell &
Snyder, 2015, p. 17), and hence to be euthanized as “life unworthy of life” (Tandler, cited in
Sheffer, 2018, p. 31), simultaneously marked others as having the potential for capacitation
(Puar, 2017), and therefore, for being put into service on behalf of the national socialist state.
Our analysis is keenly cognizant of this fraught history, but nevertheless begins with the
constitution of autism as an ontological category in the United States, in 1943. Asperger’s work
was not widely available in English translation until the early 1990s, and so cannot be directly
implicated in the commodification of autism in the United States in the intervening decades.
And, absent a conceptually coherent, unified, overarching or totalitarian nation-state as the
background context for understanding what autism does, and into whose service autistic people
are put (as was arguably the case with the emergence of Asperger’s autism in Europe at the
time), we argue that in the United States, the history has unfolded in such a way that Mitchell
and Snyder’s concept of ablenationalism may be usefully alternately understood as
ablecapitalism. That is, the state in the United States currently is arguably less defined by its
government than it is by its corporations and its plutocratic billionaire class, which effectively
deploy the levers and powers of government to advance their own private financial interests and
ends. Therefore, while the construct of autism as established and reified in Vienna in 1944 both
emerged from and subsequently served as a tool of the values and agenda of the national socialist
state of the Third Reich, in the United States, the emergence of autism as an ontological category
quickly became mobilized, not by the American nation-state, but by its capitalist class, as an idea
that would facilitate the creation of a new commodity (autistic people) that became the
foundation of myriad for-profit autism industries. Thus, the early history and reification of
autism as an ontological category in the United States can perhaps best be understood as a
process of commodification within postwar neoliberal capitalism.
Due to the geopolitical realities in Europe leading up to and encompassing World War II,
there was a fair amount of cross-pollination of ideas and expertise and indeed personnel between
the United States and Europe during the 1930s and 1940s, and a great many European
intellectuals emigrated to the United States during that time. Leo Kanner had emigrated from
Austria to the United States earlier, in 1924, but he facilitated the subsequent emigration from
Austria and Germany of many Jewish physicians during the 1930s and ‘40s (Sheffer, 2018, p.
58), including some who had been working in Vienna. Therefore, it so happened that Kanner,
writing in the United States, was the first to publish, in 1943, a paper advancing the notion of
“autistic disturbances of affective contact,” alternately referred to as autism as a distinct clinical
and diagnostic entity. The term autistic had been in use as an adjective describing the appearance
or experience of aloneness for several decades at least, but 1943 marked the genesis in the
United States of autism as a distinct (if highly culturally adaptive and fluid) ontological category.
Kanner’s (1943) presentation of these 11 case studies of a “unique ‘syndrome’ not heretofore
reported” (p. 242) was rich in descriptive detail, and he reported that several of the children were
at one time “thought to be seriously retarded in intellectual development” (p. 231), or had “what
was thought to be a severe intellectual defect” (p. 226), or that a child who “created the
impression of feeblemindedness” (p. 226) nevertheless “certainly could not be regarded as
feebleminded in the ordinary sense” (p. 228). For another several of the children, he reported that
children were referred “with the complaint of deafness” (p. 225), that “deafness was suspected
but ruled out,” (p. 239), or that it was “clearly recognized that she was neither deaf nor
feebleminded” (p. 230).
Kanner repeatedly makes specific interpretive observations about the cognitive abilities of
the 11 children. For example, of Donald, he reports that “he quickly [before he was 2 years old]
learned the whole alphabet ‘backward as well as forward,’” that “he appears to be always
thinking and thinking” (p. 218), that “he quickly learned to read fluently and to play simple tunes
on the piano” (p. 220), and that “when asked to subtract 4 from 10, he answered: ‘I’ll draw a
hexagon’” (p. 222). Of Frederick, Kanner reports that “his facial expression . . . gave the
impression of intelligence” (p. 224), and of Richard, that “the child seems quite intelligent” (p.
225). Of Barbara, Kanner reports her father’s assessment of a “phenomenal ability to spell, read,
and a good writer, but still has difficulty with verbal expression. Written language has helped the
verbal” (p. 228). Of Virginia, he reports that “she had an intelligent physiognomy” (p. 231) and
that “with the nonlanguage items of the Binet and Merrill-Palmer tests, she achieved an I.Q. of
94. ‘Without a doubt,’ commented the psychologist, ‘her intelligence is superior to this” (p. 230).
Of Herbert, Kanner reports that he “showed a remarkably intelligent physiognomy” (p. 232), of
Alfred, that “he achieved an I.Q. of 140” (p. 234), of Charles, that he was an “intelligent-looking
boy” (p. 236), and of Elaine, that she had an “intelligent physiognomy” (p. 239) with “blank,
though not unintelligent” facial expressions (p. 240). Kanner addresses the construct of
intelligence at length in his discussion:

Even though most of these children were at one time or another looked upon as feebleminded, they are all unquestionably
endowed with good cognitive potentialities. They all have strikingly intelligent physiognomies . . . . The astounding
vocabulary of the speaking children, the excellent memory for events of several years before, the phenomenal rote
memory for poems and names, and the precise recollection of complex patterns and sequences, bespeak good intelligence
in the sense in which this word is commonly used. (pp. 247–248)

Additionally, Kanner had explicitly described the children’s difficulties as “inborn” and “innate”:

We must, then, assume that these children have come into the world with innate inability to form the usual, biologically
provided affective contact with people, just as other children come into the world with innate physical or intellectual
handicaps . . . . For here we seem to have pure-culture examples of inborn autistic disturbances of affective contact. (p.
250, emphasis in original)

Each of these two initial assertions of Kanner’s—that the affective “disturbances” the 11 children
experienced appeared to be inborn, or present from birth, and that the children appeared to be
“unquestionably endowed with good cognitive potentialities” (p. 247)—continue to be pivotal
points in the highly contested and ongoing process of conceptualizing the ontological category of
“autism.”
In 1971, Kanner published a follow-up study of the 11 children profiled in his original 1943
study. In this follow-up study, published nearly 30 years later, Kanner described the sort of lives
the children grew up to lead and described each individual’s present (at that time) status.
Additionally, Kanner (1971) remarked that “the one thing that the 1943 paper could neither
acquire nor offer was a hint about the future” (p. 141). However, while the follow-up study did
not attempt to make any assertions about etiology, intervention, or prognosis, it did obliquely
raise the question of outcomes based upon the experiences of the original 11 children. Kanner
expressed his expectation that future studies will be able to provide “a more hopeful prognosis
than the present chronicle” (p. 145), acknowledging both the significance of hope in disability-
related research, and also the wide variability of outcome, depending in large part upon the
opportunities and experiences afforded (or not) by the individual families’ financial and social
circumstances.
There was arguably little in Kanner’s (1943, 1971) work that actively characterized autism as
a social problem, per se, beyond, perhaps, his characterization of the children’s experience as
“disturbance.” However, that framing contributed more to characterizing autism as a clinical
(and therefore individual) problem, not a social or societal one (recall that his 1943 piece
reported upon just 11 children that he had noticed shared certain similar clinical features—a far
cry from later decades’ subsequent framings of autism as “epidemic”). His work was
observational, analytic, and presented the 11 profiled children as whole, complex, interesting (if
curious) people whose as-yet-little-explored experiences were well worth both recognizing and
better understanding as a pattern of shared clinical experience. Beyond arguing that the observed
“disturbances” were “inborn,” he did not hypothesize at length about etiology, and he made no
prospective claims or recommendations about either intervention or prognosis. Indeed, if
anything, his follow-up (1971) piece arguably positioned (at least obliquely, through implication)
the common practice of institutionalization, not autism, as the potentially greater “social
problem.” However, an additional observation Kanner made in 1943 did, perhaps inadvertently
—and unfortunately, probably irremediably—inform the eventual framing of the emergent
ontological category of autism as a social problem.
Kanner (1943) notes of his observations of the children’s families: “There is one other very
interesting common denominator in the backgrounds of these children. They all come from
highly intelligent families” (p. 248, emphasis in original), an observation that he goes on to
describe as “not easy to evaluate” (p. 250). He also notes:

One other fact stands out prominently. In the whole group, there are very few really warmhearted fathers and mothers. For
the most part, the parents, grandparents, and collaterals are persons strongly preoccupied with abstractions of a scientific,
literary, or artistic nature, and limited in genuine interest in people . . . . The question arises whether or to what extent this
fact has contributed to the condition of the children. The children’s aloneness from the beginning of life makes it difficult
to attribute the whole picture exclusively to the type of the early parental relations with our patients. (p. 250)

And, despite Kanner’s final evaluation and firm assertion that the difficulties he observed the
children experiencing were “innate” or “inborn,” the professional (i.e., medical, psychiatric,
psychological) community appeared instead to focus its attention on this penultimate observation
of Kanner’s—that many of the children observed were born to “highly intelligent” and “very few
really warmhearted” fathers and mothers. Indeed, despite the rich descriptive detail to the
contrary, for the first 20–25 years after Kanner’s original descriptions of autism appeared in the
literature, and perhaps resulting from Kanner’s observation about the children’s families, the
prevailing professional conceptualization of autism in the United States was that of an emotional
disturbance—an extreme psychological reaction to a traumatizing experience that resulted in the
“autistic” withdrawal of the child from his or her world. Herein lies the genesis of the cultural
production of autism as a social problem in the mid-20th century United States.
One of the most influential—and potentially the most infamous—proponents of this
“psychogenic” theory of autism was Bettelheim (1967), who asserted his “belief that the
precipitating factor in infantile autism is the parent’s wish that the child should not exist” (p.
125). The psychogenic concept of the refrigerator mother as somehow precipitating the onset of
autism emerged amid decades of unhelpful and damaging psychoanalytic interventions aimed
primarily at mothers whose parenting styles were seen as causative of and hence ultimately to
blame for whatever difficulties the child experienced. Sullivan, a parent of a young autistic child
during the height of the psychogenesis period, describes the impact that this particular theory had
on many parents:

Parents who were not around in the 1950s, ‘60s, and even ‘70s trying to get a diagnosis for their (usually) beautiful young
child with extremely difficult and inexplicable behavior might have a hard time understanding the oppressive and guilt-
provoking dogma of most mental health professionals at that time. For some parents that I knew then, each time they took
their child for an evaluation, they were told that they (especially the mother) had caused the autism. Families who could
afford it went into psychotherapy or psychoanalysis. No assistance was given to the parents in handling the day-to-day
worrisome behavior of their child. The theory, acted upon as fact, was that once the parents recognized and confronted
their repressed and deep-seated anger (which caused their child to withdraw) they would then be fit to raise their
otherwise normal child. (Sullivan, as cited in Turnbull et al., 1999, p. 413, emphasis in original)

This idea that autism resulted from an emotional injury or trauma inflicted upon a child by poor
or inadequate mothering (it was almost always the mother, and rarely the father, who was
blamed for this hypothesized etiology), and its corollary logic that the mother (and the child)
would therefore benefit from psychoanalysis persisted throughout the remainder of the 20th
century. Throughout those decades, as Sullivan testifies, many parents described professional
advice beginning with recommendations of counseling for the parents rather than with
recommendations of educational intervention or other support for the child. Even in the 1990s,
this flawed and wholly unsupported narrative continued to be peddled by psychological,
psychiatric, medical, and educational professionals.
Maurice (1993) describes one doctor’s initial recommendation upon giving her a diagnosis of
autism for her young daughter, and her reaction to this advice:
“Come to our parent workshop tomorrow night . . . . The parents talk about the issues and problems that they’re struggling
with . . . . We counsel the parents on how to cope with the problems of autism and to understand their child . . . ”

“I don’t need counseling. Everyone wants to ‘counsel’ me!” . . . So many people wanted to give me counseling, therapy,
support . . . . Let me deal with my grief and fear—you show me what to do with my daughter now . . . (p. 53–54)

Maurice’s “show me what to do with my daughter now” is reminiscent of the rallying cries of
many other parents, 30 years earlier, that had culminated in 1965 in the formation of the National
Society for Autistic Children (NSAC), which is presently known as the Autism Society of
America (ASA). The formation of this parent advocacy group signaled a significant conceptual
shift that was occurring in the mid-1960s toward an understanding of autism as having a
physiological, rather than a psychological, etiology. Parents not only welcomed but were
instrumental in demanding professional recognition and exploration of a new understanding of
autism as a complex neurobiological disorder which perhaps may be precipitated by genetic
and/or environmental factors, but which certainly is not caused by “frigid” or otherwise poor or
inadequate parenting. Though the psychogenic theory of autism and its corollary psychoanalytic
intervention practices have now been thoroughly discredited as wildly inaccurate and utterly
unhelpful to either parents or their children, the legacy of Bettelheim and others who touted a
psychogenic etiology of autism lingered for decades. And hope was virtually absent as a concept
within autism discourse during those decades.

Autism and Hope (Behaviorist-Style): 1964–1987

The founding of the NSAC was spearheaded in large part by Dr. Bernard Rimland, a
psychologist and a parent of an autistic son. The conception of the NSAC followed closely on
the heels of the publication of Rimland’s (1964) text, Infantile Autism, in which he asserts “that a
careful review of the evidence has revealed no support for the psychogenic point of view. The
evidence is instead highly consistent with expectation based on organic pathology” (p. 61).
Rimland did refrain from simply taking a reductionist stance on the opposite side of the enduring
nature-nurture debate, noting that he “does not presume to have shown that autism is biologically
determined and that the psycho-social environment plays no part in its etiology” (p. 61).
However, in taking a neurobiological position on etiology, Rimland further postulated, without
offering any of the “evidence” he asserted, that “autism is the result of a cognitive defect” (p.
102), and speaks of autism as a specific “form of mental retardation” (p. 139), a markedly
different conceptualization from Kanner’s original assertion that the characteristics of children he
described as autistic were “unquestionably endowed with good cognitive potentialities” (p. 247),
and that they “bespeak good intelligence in the sense in which this word is commonly used” (p.
248). Rimland thus virtually unilaterally replaced the explanatory storyline of emotional
disturbance or withdrawal with the metaphoric narrative of mental retardation, a notion that
remains narratively entrenched to this day, despite a similar paucity of evidence to support it
(Freeman, 1997; Matson et al., 2009; Matson & Shoemaker, 2009; Rapin, 1997; Underwood et
al., 2010; Volkmar & Pauls, 2003).
Rimland’s book was favorably reviewed in the media, prompting hundreds of parents to
write letters of support and thanks for his work (Warren, 1984). In addition, early in 1965, Life
magazine had run a feature article on O. Ivar Lovaas’s work using behavior modification with
autistic children, which also generated many letters of interest from parents. According to
Warren (1984), Lovaas then “shared the letters he received with Rimland, and together they
became a resource for launching NSAC” (p. 102). In establishing the NSAC, Rimland and
Lovaas, working with Sullivan and other parents, very effectively rebranded autism as a
particular form of social problem, a “specific form of mental retardation,” which, as it happened,
could be met with the institutional response of behavioral intervention to address it. Thus, a
primary agenda of the NSAC from its inception was not only to advocate for research advancing
understanding autism as a neurobiological disability, but also to meet the more immediate
management and intervention needs of parents who were asking the question that Maurice was to
reiterate nearly 30 years later: “show me what to do with my daughter now.” Indeed, at the
organizational meeting of the NSAC in November of 1965, Warren (1984) reports that “Rimland
gave parents lists of things to do with their children” (p. 102), and Ruth Sullivan recalls of that
meeting, “We fell on each other . . . . It was heady. For the first time we had hope” (Sullivan,
cited in Warren, 1984, p. 102).

Product #2: Cultural Logic of Intervention as Institutional Response

From the very beginning of the formation of the NSAC in 1965, a behavioral discourse on
autism intervention thus played a prominent and integral role, and from that inception,
behaviorist intervention has been cast as a primary (if not the only) avenue of hope for autistic
people (or, perhaps more accurately, for parents of autistic people). Parents of young autistic
children were largely unhappy with the professional advice and services that had been offered to
them in the first several decades following the emergence of autism as an ontological category,
and they had come together to demand two fundamental changes in professional discourse
around autism: (a) a rejection of the psychogenic discourse on autism that blamed the parents for
their children’s disabilities, and (b) the development of a useful discourse on intervention, one
that might offer them what Ruth Sullivan called “assistance . . . in handling the day-to-day
worrisome behavior of their child” (Sullivan, cited in Turnbull et al., 1999, p. 413). Indeed,
during the late 1960s and early 1970s, if the emerging discourse on the etiology of autism was
organic, rather than psychogenic, in nature, the emerging discourse on intervention around
autism was behavioral, rather than psychoanalytic in nature. In fact, it could be argued that
during the mid-1960s, intervention took precedence over etiology as the most important narrative
element of the cultural production of autism as a social problem. And thus by the mid-1960s, the
two primary products of the AIC (autism as social problem and the cultural logic of intervention)
were being produced for general consumption in tandem (even lockstep) with one another within
behaviorist discourse communities.
At a time when psychiatry, psychology, psychometrics, medicine, and other disability-related
professions were pursuing ever more precise diagnoses of what was “wrong” with disabled
people and engaging in etiological hypothesizing as to why people were as they were (Rimland’s
hypothesis of autism as a specific form of mental retardation a case in point), behavioral
researchers by and large began to concentrate their efforts on intervention—how might
individuals with particular behavioral characteristics be taught? Or at least, how might their
behavior be systematically shaped and altered? This represented a significant departure from the
hopelessness of the dominant discourses of previous decades, and it pointed the way toward an
emergent discourse on “educational” (i.e., behavioral) interventions as a basis of hope for autistic
people. Families had demonstrated a strong cultural desire for hope. Behaviorists responded with
a coherent cultural logic of intervention.
However, hope emerged within this behaviorist discourse not so much in the context of the
individual child growing and learning and demonstrating his or her or their own competencies,
but rather as an increasing hope in behavioral technologies to effect change on people in spite of
their innate deficiencies. Indeed, it must be noted that early behavior modification drew upon
intervention methods that were highly aversive to the young children being “treated” and which
could hardly be considered “educational” at all—methods such as the use of contingent electric
shock and other contingent physically aversive punishments (such as slaps), and the withholding
of food in order to elicit “motivation” (hunger) in the child to perform for edible rewards
(Greenfeld, 1972; Lovaas et al., 1973). Thus, although the discourse of behaviorism on hope
began to point toward treatments and interventions that could be considered (at a stretch) to be
“educational” in nature, this emergent hope was located almost exclusively in the application of
particular treatment or intervention methods or technologies, rather than in a belief that these
young children were capable of learning, of growing, or of benefiting from an education.
Hope, therefore, has been a defining element of operant behaviorism’s brand as it related to
autism since the mid-1960s. In so branding itself, we argue that the field of operant behaviorism
laid the first ideological bricks in the architecture of the AIC, and that the production of hope vis-
à-vis a behavioral interventionist cultural logic was a conceptually defining feature from at least
1965 on. The subsequent bricks, beams, and girders institutionalizing the AIC have thus all
served to bolster an inextricable foundational ideological connection between autism and
behaviorism, bound together by an interventionist cultural narrative of hope, and to subvert and
exclude any efforts to refute, weaken, or undermine that central conceptual linkage. And that
hope, already inextricably intertwined with a cultural logic of behaviorist intervention, stood
poised to generate both revenue and profit. Indeed, by the time both behaviorism and autism
were barely 25 years old as ideas, we can already see all three central components of an
industrial complex (per Picciano & Spring, 2012) in place: ideology, technology, and profit. We
offer here a brief example to illustrate this claim.

Operant Behavioral Ideology, Applied Behavioral Technologies, and Profit

In 1968, the inaugural issue of the Journal of Applied Behavior Analysis (JABA) was published,
just ten years after the first issue of the Journal for the Experimental Analysis of Behavior—the
first dedicated publication venue for behaviorist research, and just three years after Lovaas’s first
(1965) foray into popular media in Life magazine. JABA’s stated aim was to “publish
experimental research involving applications of the analysis of behavior to problems of social
importance” (Wolf, 1968b). The first issue of JABA contains eight articles. Of the eight, four of
the articles describe classroom-based research. Two additional articles are studies of children
outside of the classroom setting—one of which, “The Effects and Side-Effects of Punishing the
Autistic Behaviors of a Deviant Child” (Risley, 1968), specifically applies operant conditioning
to the “autistic rocking” of a 6-year-old girl. The early publications in the field of ABA
constructed what a “problem of social importance” is alongside the neatly packaged intervention.
The pages are filled with definitions and descriptions of “deviance”—deviant children, deviant
behaviors, etc. And while the rhetorical construction of deviance in this issue is a study in its
own right, our purpose here is to provide an account of how this construction worked in tandem
with material conditions to create a market for behaviorism, which subsequently became a
market linked inextricably with intervention for autism. Or, to use Albrecht’s (1992)
terminology, the “construction of a social problem” simultaneously and symbiotically produced
the “institutional [interventionist] response” to that problem, which stood poised to capitalize
upon the further development and expansion of that response.
One of the unique features of JABA from its inception is the inclusion of multiple commercial
advertisements. In the late 1960s, it would be somewhat “normal” for an academic journal to
include advertisements for recently published books, or calls for proposals and forthcoming
issues in the front matter; however, advertisements of that sort do not make up the bulk of what
is included in JABA. The journal actually includes copious advertisements for behavioral
technologies and products: mechanical “feeders,” closed-circuit television systems, sensory
deprivation chambers, and shock boxes. For the purposes of illustration, we will here describe
and analyze the first advertisement to be included in JABA that explicitly mentions autism,
appearing in the third issue of the first volume, published in the fall of 1968. The advertisement
reads, “Farrall Instrument Company Announces an integrated group of quality instruments
designed for clinical and field applications of behavior modification techniques: the bug in the
ear, the wireless shocker, the wireless dispenser, the personal shocker, office desk shocker,
visually keyed shocker” (see Figure 2.1).
Figure 2.1. Commercial advertisement in JABA, 1968, from the Farrall Instrument Company, promoting a variety of products for
sale to be used in the operant control of human behavior, including their new Wireless Shocker and Visually Keyed Shocker.

Wolf, M. M. (Ed.). (1968a). Farrall Instrument Company announces an integrated group of quality instruments. Journal of
Applied Behavior Analysis, 1(3), i–xix. In the public domain.

The advertisement is unlike advertisements that occur contemporaneously in comparable

education or psychology journals in both subject matter and form. Not only is this not an
advertisement for something related to the scholarly enterprise (e.g., an upcoming conference, a
recent book publication, calls for proposals or contributions to special or forthcoming issues of
the journal, etc.), but it is also not the standard page of barely-formatted typewritten text. Instead,
it contains all of the markings (of the time) of a glossy, magazine-spread-stylized text, layout and
logo design. The ad describes two new instruments: the “wireless shocker” and the “visually
keyed shocker,” and while these products are intended to be used to shock human beings, the
information is presented enthusiastically, as one might present a new line of televisions or
washing machines for sale to the post-war, ascendant or aspiring middle-class American
consumer. The wireless shocker is described as such:
A true Wireless Shocker. By using radio control, you can deliver a shock to a patient up to 1000 feet away with no
connections. Now behavior modified in the laboratory or office situation may be subjected to generalization and
discrimination training more closely approximating the situations to which the behavior must be transferred. The device
has been effectively used with head-bangers and other autistic behavior. (Ed. Wolf, 1968a)

Here we see the “autistic headbanger” (a close cousin of the autistic shit smearer; for an analysis
of shit-smearing, see Yergeau, 2017), the dangerous and in-need-of-intervention. This is the type
of autistic that is dutifully trotted out to justify a litany of interventions. The narrative is that
autistics bang heads; ergo, autistics must be shocked. And while this advertisement is meant to
literally sell the device that shocks the autistic headbanger, the issue itself is both selling shock
boxes (please write for details such as pricing) and the need for intervention that requires
autistics to be shocked, to say nothing of the identity of autistics as headbangers. And, of course,
as nearly every other commercial product ever sold to consumers, the shock boxes and other
products on offer were also selling a particular vision of hope (in this case, in relation to the
“problem” of autism).
By the early 1970s, hope was something that had begun, cautiously, modestly, to be talked
about in the behavioral discourse on autism. Perhaps the most significant of the early behavioral
studies was conducted by Lovaas, Koegel, Simmons, and Long (1973). In this early study, the
authors acknowledge the significance of hope in this field when they note that previous attempts
to treat autistic children with behavioral treatment “carried with them a promise of help and a
certain optimism for the autistic child,” which the authors say “contrasted with the general
hopelessness” (Lovaas et al., 1973, p. 132) that had come of the previous generation’s attempts
at psychoanalytic treatment of these children (and/or their mothers). The authors describe the
purpose of employing these procedures as “making the child look as normal as possible” (p.
135). The vision of hope that Lovaas and his colleagues held out in the early 1970s was a
somewhat cautious one; however, it is clear that this vision of hope was conceptualized based
upon attainment of “normalcy” as its ideal, if unlikely, desired outcome. The linking of this hope
to promises of “normalcy” is one that would continue to be developed, refined, and expertly
branded by behaviorists over the coming decades (see Chapter Four). Thus, during these
decades, behavioral ideologies, behavioral technologies, and the economic architecture to
generate potential profit were wrapped up in hope and sold directly to parents of autistic children
and to the professionals at the segregated institutions that housed and/or “educated” them.

Add Neoliberal Capitalism and Stir = Autism Industrial Complex

Autism had materialized as a concept (Kanner, 1943; Asperger, 1944) fewer than 25 years before
this inaugural issue of JABA was published, a journal that clearly positioned autism (and
therefore, autistic people) as primary targets of ABA intervention (products and services). Thus,
the basic foundations of the industrial complex were laid, by the late 1960s, primarily by
academic behaviorists: the ideology of behavioral psychology was explicitly linked with both
hope and with the technologies of ABA and its associated commercially available gadgets, with
the population of autistic people targeted as objects of this potentially profitable market
(ideology, technology, profit). But the problem (for behaviorists) at the time was that few people
noticed; apart from reputational currency for a few high-profile academics, and perhaps a few
checks coming in on the side from the sale of “wireless shockers” and other such products,
mostly to institutions and segregated special education schools, comparatively little capital was
generated.
A lesson of neoliberal capitalism as it developed through the 1980s and ‘90s has been that
while the rhetoric of free markets is indeed paramount to the ideology, in truth, greater profit is
often generated if markets are not entirely free, but rather are mediated somewhat through subtle
(though effective) forms of government intervention or influence (e.g., legislation, regulation,
policy initiatives, “awareness” campaigns, etc.), supported by the rhetorical equivalent of cultural
carpet-bombing through skillfully deployed mass media and propaganda initiatives. Almost any
entrepreneur will attest to the fact that a product, no matter how promising or innovative or
groundbreaking (in this case, behavioral technologies), may be insufficient on its own to
generate substantial profit when it first is offered in the marketplace, particularly if the market’s
consumers have not yet been adequately groomed for their role in consumption. Thus, a basic
lesson of Marketing 101 is that if one wishes to turn a profit, one not only must manufacture
one’s product, but also and simultaneously must invest in manufacturing the market for one’s
product and, therefore, one’s targeted consumers. By the early 1970s, the basic components of
the industrial complex were in place (they were explicitly branding and marketing hope and an
interventionist cultural logic in relation to the “social problem” of autism, a.k.a., “head bangers,”
together with both products and services for sale as behavioral technologies), with little to no
significant profit generation for behaviorists. How, then, did the industry of ABA become a
multibillion-dollar-a-year industry only a few decades later? The basic interventionist
technologies of ABA today are virtually unchanged from the operant behaviorist technologies of
the 1960s. What changed? It was not the ideology of operant behaviorism, nor its associated
technologies (ABA): what changed was its rhetoric, and therefore, its tactics and strategies to
brand and market itself.
Central to the analytic excavation of the AIC is the recognition that neoliberalism “operates
not only as an economic system, but as a political and cultural system as well” (McChesney,
1998, p. 9). McChesney contends that the central explicitly espoused ideals of neoliberalism—
e.g., free markets, individualism, consumer choice, individual responsibility, freedom, etc.—
have attained a “near sacred aura” largely by means of “a generation of corporate-financed
public relations efforts” (p. 7). And indeed, the rapid ascendance of the AIC during the 1980s
and ‘90s, and its widespread dominance by the early 2000s, is due in no small part to lessons
learned from the maturing political economic ideology of neoliberalism: that public relations
(PR) needs be a foundational investment, that effective branding is existential, and that the very
first product one must invest in producing is one’s targeted consumer, thereby creating the
market for one’s primary products. Hope is a magnificent inducement to consumption, but
deploying it only to the relatively narrow targeted market of parents of autistic children already
participating in organizations such as the NSAC had not yet, by the early 1980s, yielded a highly
profitable industrial complex. Autism successfully commodified? Check. A narratively coherent,
cultural logic of intervention, linked with that commodity and jointly offered for consumption?
Check. What else do we need? Ah, yes—more (and more willing) consumers.
An additional lesson learned from neoliberalism is that everyone is a potential, latent
consumer and must be groomed and cultivated as such in order to maximize potential future
profit generation. Indeed, in general, it is arguably necessary for widespread segments of the
population to identify with and then buy into the interests of the plutocratic and ruling classes as
if they were shared interests, in order for people to support (or at least, not to resist) policies that
in many cases are actually contradictory to one’s own economic interests. It is the widespread
consumption of the ideologies of freedom, individualism, meritocracy, and choice that produce
the necessary consent to neoliberal economic policies writ large. This is neoliberalism operating
as a political and cultural system. And so it was, in the 1980s (the first heyday of neoliberalism
in Reagan’s America and Thatcher’s Britain), that the widespread, deep foundations of the AIC
took hold. Everyone (not just the parents of autistic children) became targeted as consumers of
both autism, ontologically constituted as a social problem, as well as its corollary cultural logic
of intervention. And consequently, the autism intervention industry boomed.
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Volkmar, F. R., & Pauls, D. (2003). Autism. Lancet, 362(9390), 1133–1142. https://doi.org/10.1016/S0140-6736(03)14471-6
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PART TWO

(Re)Branding and Marketing the AIC:

Manufacturing Markets, Consumers, & Consumer
Confidence (1987–present)

T HE AIC MARKETPLACE IS produced by at least four different networks of players, each of

which is intimately connected with the field of operant behaviorism, generally, and with the
applied technologies of Applied Behavior Analysis (ABA), more specifically. These include: (a)
academic behaviorists; (b) nonautistic parents of autistic children; (c) the Behavior Analyst
Certification Board® (BACB®); and (d) Autism Speaks. These players anchor a network of
interrelated activities and ventures and together comprise the foundational plutocrats of the AIC,
each of which currently participates in some way in the commodification of autism and autistic
people, as well as the concurrent manufacture and branding of its market for those commodities
through producing both interventionist, and additionally, emerging around 1995, preventionist
logics for public consumption.
Part Two analyzes the (re)branding and marketing efforts that form the ideological
infrastructure of the AIC. This rebranding campaign was initiated and successfully conducted
primarily by the first two networks of plutocratic players from approximately 1987–2000: (a)
academic behaviorists, and (b) nonautistic parents of autistic children. Specifically, Part Two
analyzes the systematic and skillful rhetorical deployment of the cultural politics of hope, of
truth, and of fear in the (re)branding and marketing of the AIC. Thus forms the foundational
rhetorical, conceptual, ideological, cultural, and epistemological apparatus of the AIC.
CHAPTER THREE

Rhetoric and Neoliberalism:

On (Re)Branding and Consuming Hope

F ROM OUR CURRENT TEMPORAL vantage point (2022), few would dispute Harvey’s (2007)
assessment that neoliberalism as an organizing mode of political and economic thought has
been globally ascendant since the 1970s, nor his contention that neoliberalism has “become
hegemonic as a mode of discourse” and that it therefore “has pervasive effects on ways of
thought to the point where it has become incorporated into the common-sense way many of us
interpret, live in, and understand the world” (p. 3). Neoliberalism’s ideals and tenets became
personified in the work and the reach of economist Milton Friedman, whose academic post at the
University of Chicago enabled him not only to train a generation of economists in his ideological
image (rather than in Keynesian economics, the school of thought that had enabled global
economic reconstruction following the Great Depression and World War II), it also enabled him
to directly and powerfully influence U.S. policy, both foreign and domestic (Harvey, 2007;
Klein, 2007). Harvey’s coherent historical analysis of the emergence and entrenchment of
neoliberalism during the last decades of the 20th century (which constitutes the economic,
political, and historical/cultural backdrop for the emergence of the AIC) is instructive in that he
highlights at a macro (economic) level what I analyze here (in the AIC) as a subset of that whole.
In order to understand and even to perceive (let alone to resist or subvert) neoliberal
economic structures and policies, one must first apprehend their foundational ideas, concepts,
and ideals. To that end, Harvey (2007) reminds us that:

For any way of thought to become dominant, a conceptual apparatus has to be advanced that appeals to our intuitions and
instincts, to our values and our desires, as well as to the possibilities inherent in the social world we inhabit. If successful,
this conceptual apparatus becomes so embedded in common sense as to be taken for granted and not open to question. (p.
5)

Harvey concedes that the concepts of human dignity and individual freedom—neoliberalism’s
most basic and foundational explicitly espoused ideals—are “indeed compelling and seductive”
(p. 5). And that is precisely the point. Had neoliberalism explicitly espoused as its touchstone
ideals unfettered avarice in the accumulation of private and corporate wealth, and the relentless
pursuit of that gain with an indifference bordering on contempt toward both natural and human
resources, it seems less likely that it would have emerged, spread, and flourished so rapidly in so
many disparate regions of the globe in the latter decades of the 20th century. The ideals
themselves must be compelling and seductive in order for a conceptual apparatus to be
successfully advanced to the point of becoming hegemonic—that is, embedded as common
sense, taken for granted, not open to question—in the ways that we understand and live in the
world. All of which is to say that, in our brave, new, neoliberal world, the narrative matters.
Branding matters.
The multibillion-dollar-a year autism intervention industry did not emerge out of thin air
because a critical mass of very plucky and talented behaviorist entrepreneurs hung out their
small-business shingles in the late 1980s and early ‘90s and just happened to do well for
themselves selling wireless shockers and 1:1 discrete trial instruction (complete with contingent
aversives) levied against 2-year-olds. Nobody would have lined up to buy some of that for their
child. The industry emerged and became profitable because the industrial complex was
successfully forged—that is, a conceptual apparatus was advanced that appealed strongly to
many people’s intuitions, instincts, values, and desires, and that appealed strongly to the
dominant collective’s (in this case, nonautistic people’s) sense of possibilities inherent in the
social world: hope, recovery, normalcy, and science. These are indeed compelling and seductive
ideals. It is this conceptual apparatus that was successfully advanced in the last two decades of
the 20th century by academic behaviorists and nonautistic parent advocates and that has now
successfully taken hegemonic hold of our collective cultural desires and hopes in relation to the
ontological category of “autism” (and therefore, in relation to autistic people). And this
conceptual apparatus has only become more entrenched in the intervening decades.

Rhetorical and Ideological Architecture of the AIC’s (Re)Branding Campaign

A mere 20 years after JABA emerged on the scene, a series of game-changing related events
jumpstarted—indeed supercharged—the growth, development, entrenchment, and global
exportation of the AIC. I have previously referred to several of these events as watershed
rhetorical moments (Broderick, 2011) in autism/ABA discourse, but in this section they will be
further and explicitly explored as (re)branding efforts in the context of a neoliberal capitalist
economy that collectively constitute core beams and girders in the ideological architecture of the
AIC.
One of the pivotal contributions of disability studies (DS) scholarship in recent decades has
been the incisive excavation of the ways in which disability constitutes and operates as a
complex system of cultural representation—of rhetorical and discursive practices, ideologies,
and always, of power. Dolmage (2018) writes that:

Rhetoricians focus on how language is used to persuade. More than this, rhetoric focuses on the ways that rhetoric shapes
not just utterances or inscriptions, but also beliefs, values, and even bodies. Rhetoricians foreground the persuasive
potential of all texts and artifacts, linking language to power and reminding us that sometimes, unfortunately, the ways
that messages are shaped, delivered, repeated, and recirculated can be just as important as their veracity, facticity, or
truthfulness. (p. 2)

Dolmage excavates the rhetorical history of eugenic sentiment in anti-immigrant political

rhetoric, illustrating how, for the last century, such claims “have been both totally false and
scarily effective” (p. 3) at inciting anti-immigrant sentiment, including hate and violence.
Dolmage argues that disability studies “offers an ideal set of methodological tools for wading
through this rhetoric,” in particular, that of “‘reading’ sideways, or searching for ‘crooked’
meanings” (p. 3).
This analysis, in effect, is a DS analysis that reads autism discourse sideways, or obliquely—
that rejects a foveal, face-value analysis of what is said in favor of a peripheral, “crooked”
analysis of what is meant and rhetorically accomplished. Rhetoric is of course an inherent part of
systems of representation through language and other signifiers, and because autism is
fundamentally discursive, it cannot exist outside of, or prior to, rhetoric. Indeed the genesis of
autism as an ontological category was a fundamentally rhetorical event, and since that time, the
ongoing struggle over what autism is, what it means, what it does, and who gets to say has been
waged in the spheres of public opinion, popular culture, education, and media, all fundamentally
rhetorical cultural spheres. This should not be surprising, as rhetoric is a primary modality
through which a conceptual and ideological apparatus is advanced in popular culture and media.
And economic hegemony nearly always follows and is built, both upon and with/in, rhetorical
and ideological hegemony.
Rhetoric is, and always has been, integral to what autism means, what it is, and therefore
(crucially), what it does. Indeed, Heilker and Yergeau (2011) posit that, “whatever else it may
be, autism is a profoundly rhetorical phenomenon” (p. 486). They further argue that, given the
relative instability of the shifting terrain of ontological and epistemological claims about autism,
we must “shine a bright and insistent light on how brazenly rhetorical any utterance, especially
any highly visible utterance, about autism really is,” and further, that “every public text on
autism is begging for a rhetorical analysis” (p. 486). Yergeau (2017) further contends that autism
is “a constellation of stories” (p. 20), and that the crucial question at risk in understanding autism
as rhetoric is “who tells my story,” and “who gets to author our individual and collective
identities” (p. 21). Who writes the script? Who controls the cultural narrative? Who gets to say
what could or should be desirable, appropriate, or dominant ways of living within,
understanding, interacting with, responding to, or experiencing autism’s shifting ontology at any
given historical moment? That is, how might one’s rhetorical and ontological understanding(s) of
what autism is directly inform (and constrain), in very material ways, the ways in which one is
likely to experience being autistic? Having an autistic child, neighbor, student, partner, or
colleague? What material realities do particular rhetorical understandings of autism create? What
material possibilities might they obscure? What forms of violence might rhetoric and cultural
narratives perpetrate (and perpetuate) upon autistic people? (Broderick, 2010; Broderick &
Ne’eman, 2008; McGuire, 2016; Roscigno, 2019, 2020).
Both creating and obscuring particular material and economic realities are fundamental
outcomes of (re)branding efforts, and cultural rhetoric is a key tactic deployed in any branding
effort. What I initially understood as essentially powerful rhetorical moves (Broderick, 2011), I
now understand fundamentally and more specifically as branding efforts within the AIC—that
is, rhetoric in service of capital. It becomes a branding exercise when rhetoric is deployed in the
service of not just fostering a cultural need, but manufacturing a market; not just shaping the
perceptions of citizens, but producing consumers; and not just claiming the legitimacy of one’s
efforts, but deploying massive public relations campaigns to mass-produce consumer confidence
in what one is selling, and indeed, working thereby to corner the market on it. Harvey (2007)
notes that a key element of the architecture of neoliberalism is the recognition that, “if markets
do not exist (in areas such as land, water, education, health care, social security, or
environmental pollution) then they must be created, by state action if necessary” (p. 2). Beyond
manufacturing markets, a keystone of neoliberal ideological architecture—perhaps most
crucially—is the effective branding of one’s product in relation to that market, when rhetoric is
deployed not to position what one is selling as the best alternative, but rather as the only
alternative (McChesney, 1998). (An analysis of this particular tactic is explored in Chapter
Four.) In the 1980s, as neoliberalism was seizing widespread hold of American, British, Chinese,
and other economies globally, it should come as no surprise that autism intervention was seized
upon as a sphere ripe for market creation and exploitation through deployment of both the
rhetorical and the economic tools of neoliberal capitalism.
 If autism has been successfully commodified (Mallet & Runswick-Cole, 2016) (and it has),
that commodification has been achieved not merely through rhetorical moves, but crucially, also,
through the entwining of that rhetoric within the structures and at the service of the neoliberal
political economy. The work of the industrial complex consists not only in imbuing the
ontological category of autism with particular cultural meanings, but also, in so imbuing,
transforming it into a successful commodity by preparing for its widespread consumption. The
foundational products of autism and the cultural logic of intervention are actively marketed for
consumption via the production and consumption of other, more primal, and more viscerally
powerful ideological products—the pudding, if you will, in which the pill is wrapped. The
successful commodification of autism over the last 75 years has relied in no small part on
wrapping ideas about autism and autism intervention in an irresistible, binding pudding that
nonautistic people have proven happy, even eager, nay, desperate to consume: hope that existing
autistic people may (through intervention) be made less autistic, and even, by extension, hope for
the possible future absence of the very ontological category in question—hope for the eventual
absence of autism (and therefore, of autistic people). Thus, although wireless shockers and
behavioral therapies and deficit-ridden ideas about autism had been on offer in the early decades
that laid the foundations of the AIC, the dramatic scaling up of the autism industry that began in
the late 1980s turned in no small part on the fulcrum of the deployment of a brilliant and highly
successful marketing campaign that in the late 20th century effectively rebranded behaviorism’s
vision of hope in relation to autism.

Watershed Rhetorical Moments in Building AIC’s Ideological Architecture

There have been several watershed rhetorical moments that continue to shape the cultural politics
of autism decades later (Broderick, 2011). The first two of these can be understood, in tandem, to
constitute a successful rebranding and marketing of hope within ABA discourse about autism.
The first of these moments was the 1987 publication of O. I. Lovaas’s treatment effect study,
which introduced the rhetoric of recovery from autism and linked this rhetorical construct with a
particular intervention methodology—ABA. Lovaas’s media savvy was undoubtedly indebted to
Skinner, who had advertised his climate-controlled child-rearing chamber—the AirCrib—in the
popular press (Skinner, 1945). Lovaas, however, not only embraced popular media in marketing
his intervention, but also shaped public consciousness through introducing the rhetoric of
recovery. Just as television and internet ads are really selling you promises of youth, health,
virility, sex appeal, etc. (rather than the supplements, cosmetics, clothing, or gadgets that will
arrive in the mail if you succumb), so, too, is the rhetoric of recovery within the AIC selling you
promises of a hoped-for “return” to “normalcy” for one’s autistic child. Indeed, Lovaas (1987)
changed the face of autism rhetoric as we currently know it, introducing in his publication the
rhetorical constitution of the notion of “recovery” from autism and, importantly, the explicit
linking of a particular intervention approach (ABA) with that construct (see Chapter Four).
The second moment consisted in the 1993 publication of Catherine Maurice’s
autobiographical account of employing Lovaas-style ABA intervention programs with her two
young autistic children (Broderick, 2011). Maurice’s New York Times bestseller shaped the face
of contemporary autism rhetoric by popularizing Lovaas’s rhetoric and widely disseminating it
into American popular culture. Her memoir created a vehicle for this rebranding effort that was
infinitely more consumable by the general public than any masterfully crafted report on a
treatment-effect study in an academic journal could hope to have been. This beautifully written
and itself rhetorically masterful memoir both (a) popularized Lovaas’s rhetorical construct of
recovery and (b) reiterated its exclusive linking with ABA. However, in addition to making
Lovaas’s rebranding of hope in ABA discourse better available for mass consumption, her text
also offers its own unique contribution to the rebranding effort, arguably just as (if not more)
significant: the rhetorical constitution of ABA methodology as being the “only” “scientific”
intervention approach for young autistic children. Thus, Maurice’s memoir created a platform for
mass-market consumption of ABA’s rebranding of hope in relation to autism, while
simultaneously grooming consumer confidence through appeals to another powerful, viscerally
basic vocabulary that people were eager to consume—the rhetoric of positivist science as
grounds of the brand’s legitimacy (and consequently, its virtually monopolistic market share)
(see Chapter Five).
As previously noted, hope had been an integral feature of a behavioral discourse on autism
intervention since at least 1965; however, there really was no large-scale autism intervention
industry in the 1960s, ‘70s, or ‘80s beyond the existing infrastructure of special schools and
institutional settings. The autism industry emerged in the early 1990s, and the subsequent
chapters in this section will illustrate the efforts made from 1987 on to manufacture a larger
market, more willing consumers, and greater consumer confidence in the ABA technologies on
offer during that time (as sales of the wireless shocker on its own were never going to make
anyone’s fortune . . . ). Thus, 1987 marks the public-facing launch of a determined and largely
successful rebranding effort that consolidated the rhetorical architecture of the AIC, and in so
doing, significantly scaled up the profit-generating potential of the autism industry.

Rebranding Hope

In 1987, O. I. Lovaas published the results of a treatment-effect study he referred to as the Young
Autism Project (YAP). In this publication, Lovaas’s rhetorical usage of the notion of “recovery”
from autism constitutes an implicit rhetorical claim of “recovery [to normalcy].” In reporting on
the results of the YAP, Lovaas (1987) uses the term recovery or recovered multiple times in
either direct or implied reference to what he alternately refers to as the “best outcome” or
“normal functioning” group, a group of nine children that constitutes 47% of the 19 children in
the study. The piece is a rhetorical masterpiece (an admittedly unusual assessment of an
academic report on a treatment-effect study), and throughout the manuscript Lovaas’s careful
usage of the term recovery in conjunction with normal functioning implies that 47% of the
children in the study (i.e., nine children) achieved “recovery” (to normalcy) as a direct result of
the treatment intervention: 40 hours a week of ABA discrete trial instruction, inclusive of the
systematic use of contingent rewards for desired behavior and of contingent aversives (slaps) as
punishment for undesired behavior. It is this rhetorical usage of the construct of recovery (to
normalcy) that has been the basis of the profound impact that this study has had upon
contemporary autism discourse and the rebranding of hope within ABA discourse and,
consequently, the successful scaling-up of the autism intervention industry.
Whether wittingly deployed or not, and implicit though it may have been, ABA’s discourse
on “recovery [to normalcy]” is nevertheless eerily reminiscent of President Warren G. Harding’s
“Return to Normalcy” campaign slogan, analyzed in detail by Dolmage (2018), examining the
role of immigration restrictions and eugenic rhetoric in Harding’s rise to power. Dolmage
describes how, “in his famous 1920 speech on ‘Readjustment,’ Harding used (or perhaps even
invented) the term normalcy to describe an idealized state, attainable once America was again at
peace and had closed its doors to foreigners” (p. 38). Harding’s “Return to Normalcy” slogan
focused on “reclaiming a past version of the country” (p. 39), which Dolmage points out is
conceptually reprised in Donald Trump’s 2016 “Make America Great Again” campaign slogan.
Both of these regressive nationalistic and xenophobic slogans aiming to “reclaim” an idealized
(Whiter) memory of America bear striking rhetorical resemblance to the AIC’s attempts to
“recover” an idealized (less autistic, or earlier presumed-to-be-nonautistic) child. In his campaign
speeches, “Harding was promising to return the United States to its status before World War I”
(Dolmage, p. 39), just as Lovaas was understood by many parents to be making a qualified
promise (a 47% chance) to return their autistic child to the status they’d believed their child to
have held before their labeling as autistic: to normalcy. And not unlike Harding’s rhetoric, the
rhetoric of “recovery” in ABA discourse is similarly eugenicist in its hoped-for vision of a world
without foreigners/aliens/autistics. Yergeau (2017) points out that

We still haven’t empirically answered whether or not ABA can rewire autistic brains, even if the rewiring is merely a
neuro-closeting. But presupposing ABA could rewire autistic brains, should we? (Rhetorical question. The answer is fuck
no.) (p. 133, emphasis in original)

Nevertheless, the strategy of deploying a powerful rhetorical device in an academic report of a

treatment-effect study, coupled with the narrative power of the particular rhetorical device that
he employed (the notion of “recovery” from autism) together mark Lovaas’s (1987) publication
as a significant moment in autism’s rhetorical and rebranding history, precisely because of the
profound and enduring cultural impact of Lovaas’s rhetoric of recovery.
The operational definition of best outcome in the Lovaas (1987) study was defined as
participants achieving “normal-range IQ scores and successful first grade performance in public
schools” (p. 3), and 47% of the treatment group were described as “best outcome.” These
findings may be significant, impressive even (perhaps), but are not particularly culturally
provocative—nine children, following Lovaas’s intervention protocol, went on to successfully
complete first grade in a public school classroom. Many autistic children have normal-range (or
higher) IQ scores and even more successfully complete first grade in public school classrooms.
However, recall that this 47% constituting “best outcome” within the treatment group were
alternately referred to in the manuscript, both directly (twice) as well as implicitly (multiple
times), as “recovered.”
Nine autistic children (of 19 children in the study)—nine—following participation in the
study, scored in the average range on the Weschler Intelligence Scale for Children—
Revised(WISC-R), and successfully completed first grade in a general education classroom and
were promoted to second grade. Nine kids. That was the source of the widespread cultural furor
(and fervor) following Lovaas’s (1987) publication. Any honest educator or researcher can tell
you that “successfully completing first grade” is about as slippery and nonreliable an outcome
measure as one could possibly come up with. An autistic child’s “successfully completing first
grade” is as dependent upon the beliefs, biases, and assumptions of the teacher; the relative skill
and pedagogical experience of the teacher; the culture of special education referral and
intervention (Harry & Klingner, 2014) in any given school building; and the entitlement, cultural
capital, and advocacy skills and resources of the child’s family as it is upon any individual
characteristics of the child him/her/themself (and quite possibly more so). Nine autistic children
successfully passing first grade and being promoted to second grade cannot possibly account for
the “buzz” around Lovaas’s work. It was (and is), rather, the rhetorical framing (i.e., rebranding)
of these “best outcome” data in terms of recovery from autism, rather than the data themselves,
that proved to be so culturally provocative and enduring.
People who read these findings (and particularly those who read subsequent popularized
publicization of these findings) do not hear, “nearly half of children who participated in this
research protocol successfully completed first grade in public schools,” or “nearly half of
children who participated in this protocol acquired the linguistic and motor skills necessary to
participate in and successfully respond to standardized IQ tests.” People who read (and more
importantly, who read about) this study hear, “nearly half of all children who participated in this
protocol have recovered” or (implicitly) “nearly half of all children who participated in this
protocol are normal now.” And the implicit rhetorical “therefore” of these findings is, “and if
your [autistic/disabled/abnormal] child participates in an identical (or even similar) intervention
protocol, your child also has nearly a 1 in 2 chance of being normal again.” According to Cohen
(1998),

That word “recovery,” the rallying cry of parents of young children with autism who believe in Lovaas and Catherine
Maurice, a word otherwise unheard in relation to autism, is a word with an implied promise: normalcy. Your child can be
normal. (pp. 158–159)

Lovaas’s rhetorical construct of “recovery [to normalcy]” has proven to be so powerful and so
culturally resonant for nearly 35 years now precisely because it taps into nonautistic parents’
hopes for their children while simultaneously tapping into their fears, grounded though they both
may be in ableist cultural values. Thus, nonautistic parents’ cultural fears of abnormalcy, of their
child being disabled—fears arising from the deeply ableist culture in which we are all immersed
—are assuaged by and countered with a deeply resonating (though no less ableist) rebranding of
hope within ABA discourse: Your child can recover. Your child can be normal again. Why on
earth would you do anything else? “What are they selling you?” Wang (2018) would have me
ask. They are selling nonautistic parents the hope, if not the promise, of “normalcy” for their
autistic (read: “abnormal”) child. And how many of us can honestly say we wouldn’t be tempted
to buy some of that?
Lovaas’s (1987) treatment-effect study thus appears to have been undertaken, written, and
published in large part as a rebranding initiative of the ABA intervention industry. As an
illustration of this argument, I offer here a brief overview of the nature of the initial branding of
hope that behaviorist discourse offered for parental consumption in the 1960s and ‘70s and
follow that with an illustration of the sudden and distinctive shift in their specific branding of
hope that occurred post-1987.

Hope (Behaviorist-Style), Mark One

As was illustrated in the previous chapter, discourse and practice around intervention for young
autistic children prior to 1987 were historically dominated by psychological and medical models
of deficit or deviance (Baron-Cohen, 1995; Bettelheim, 1967; Rimland, 1964; Rutter, 1978),
models that had not offered parents very much in terms of positive visions of hope for their
children. Indeed, for the first 25 years following the emergence of the ontological category of
autism in the United States, the discourse around autism was frequently silent on the issue of
intervention or supports, offering parents at best a noncommittal response from professionals in
relation to their queries, and at worst, little better than half-hearted recommendations of
psychotherapy for the mothers coupled with catastrophic visions of potential or even imminent
institutionalization for their children.
Even for those parents fortunate enough not to have had a professional recommend that their
autistic child be institutionalized, parents nevertheless often reported a sense of helplessness and
a conspicuous absence of anything that might be characterized as distinctly hopeful in the
context of intervention and prognosis for their child. Park (1967), upon receiving a diagnosis of
autism for her young daughter, reports a doctor’s advice to “‘Take her home . . . give her plenty
of affection . . . let me know how you get along . . . . ’ [This was accompanied by] a little shrug
of helplessness, sympathy, regret” (p. 40). Some 20 years later, upon receiving a similar
diagnosis for their son, Christopher and Christopher (1989) report a doctor’s primary advice to
“take him home and love him. There is nothing else you can do” (p. 25).
Yet throughout the 1950s and ‘60s, there was an increasingly cohesive and intertwined
relationship between the discourse around intervention for autistic children and the discourse
around the nature of autism itself. That is, during these decades we can see that changes in ways
of conceptualizing, talking about, and practicing particular interventions for young autistic
children in large part also informed (and in many ways directed) changes in ways of
conceptualizing and talking about what autism was considered to be (i.e., the specific nature of
the “social problem” that is autism shifts depending upon the specific nature of the dominant
interventionist logic proposed—and marketed—to address it). When the primary intervention
that psychology had on offer in the 1940s was psychoanalysis, it should perhaps not have been
surprising that an isolated observation (that there were few “warmhearted” parents among the
children’s families) made by Kanner (1943) in his original study was seized upon as the germinal
basis for a psychogenic etiological narrative, despite the fact that the bulk of his analysis
explicitly disavowed such a conclusion. Doing so neatly created a commonsense narrative
congruence between purported etiology and the dominant intervention available on the market.
However, with the formation of the National Society for Autistic Children (NSAC) and
Rimland’s replacement of a psychogenic etiological narrative with a neurobiological one, the
tight relationship between etiological narrative and intervention narrative slipped somewhat, as
behavioral intervention less logically follows from Rimland’s narrative that autism constitutes a
specific inborn form of cognitive defect. At this point, there was something of a split in what had
(for a couple of decades) been a very close relationship between discourse around etiology and
intervention practices in relation to autism. In fact, in applying the tenets of operant conditioning
to young autistic children, Lovaas and other behavioral researchers for the most part explicitly
disavowed any intent to theorize around the etiology of autism (Lovaas, 1971; Lovaas & Smith,
1989; McEachin et al., 1993). Lovaas and his colleagues claimed to only be interested in
effecting change on the observable behaviors exhibited (or not exhibited) by autistic children.
However, while behavioral researchers at this time disavowed interest in theorizing an
etiology for autism, they nevertheless largely adopted as an underlying assumption Rimland’s
assertion that autism was a specific form of, or at very least was very often associated with,
mental retardation (an assertion that had little more evidence to support it than did the
psychogenic etiological hypothesis). And although this marrying of the neurobiological deficit
etiological narrative with the behavioral interventionist narrative appeared in some ways to be a
progressive development in 1964, it nevertheless in rather short order presented behavioral
researchers and interventionists with something of a dilemma in terms of narrative and branding.
If the NSAC and its affiliated behaviorist researchers posited the social problem of autism to be a
specific form of organic, neurobiological mental retardation (as Rimland asserted, and as Lovaas
and other behaviorists did not dispute), then no matter how effective behavioral technologies
may be at altering specific challenging or troublesome behaviors (or shaping and building upon a
paucity of particular desired behaviors, such as language), one is still (logically) left with a child
that one has just asserted is organically, biologically, neurologically defective. Therefore, the
NSAC’s etiological narrative of mental retardation artificially imposed a limiting ceiling upon
the heights of the hope that behaviorist intervention could market for consumption during the
1960s and ‘70s, as they set about the task of manufacturing and disseminating the widespread
cultural logic of (behaviorist) intervention.
That limiting conceptual ceiling that a behaviorist discourse had self-imposed upon hopeful
visions of the future in relation to autism was evident in parent accounts of the time. Without a
doubt, by the early 1970s, hope was something that began only cautiously, and very modestly, to
be talked about in the behavioral discourse on autism. Greenfeld (1972) describes the cautious
vision of hope Lovaas himself offered to him when his son, Noah, began behavioral therapy at
UCLA:

But again he warned me that an autistic or schizophrenic child who undergoes behavior therapy will usually not end up
anywhere near normal, that his progress at best can be compared to climbing the first step of a ten-step ladder. (p. 129)

Indeed, Lovaas himself was a keynote speaker at the second NSAC conference, held in 1970,
and he remarked to the conference attendees at the time:

The program does not turn out normal children, and should a child become normal as we treat him, then that, no doubt, is
based on the fact that he had a lot going for him when he first started treatment. (Park, 1971, p. 39, cited in Cohen, 1998,
p. 82)

The vision of hope that Lovaas held out in the early 1970s was a somewhat cautious one;
however, it is clear that this vision of hope was conceptualized based upon attainment of
“normalcy” as its ideal (if unlikely) desired outcome. Although the behavioral discourse in the
1970s did not claim that its intervention strategies could produce “normal” children out of
“autistic” ones (and indeed, if that happened, they admitted it unlikely to be the result of
behavioral intervention), there is a clear valuing of “normalcy” as a hoped-for and desired
outcome, one that it is presumed that nonautistic parents share. Thus, in extending to those
parents the hope that their children may learn, grow, and “progress” with behavioral intervention,
the discourse simultaneously cautions parents against raising their hopes too high—reminding
them that “the program does not turn out normal children.”
It must have been somewhat disconcerting to Lovaas and other behaviorist researchers in
1971 to read Kanner’s follow-up manuscript documenting the adult outcomes of the original 11
children he had profiled in his 1943 manuscript, “Autistic Disturbances of Affective Contact.”
Kanner (1971) reminded his audience that in the 1943 manuscript he had necessarily been unable
to predict, project, or otherwise comment upon the potential future lives that lay before the 11
children so carefully described and documented in his original paper. However, he also remarked
that, in retrospect, “One cannot help but gain the impression that State Hospital admission was
tantamount to a life sentence . . . a total retreat to near-nothingness” (p. 144), and further, raised
the question of “whether these children might have fared better in a different setting or whether
Donald and Frederick, the able bank teller and the duplicating machine operator, would have
shared the dismal fate of Richard and Charles in a State Hospital environment” (p. 144).
By simply documenting the adult lives of Donald and Frederick, who were gainfully
employed and meaningfully participating in their broader communities as successful autistic
adults, and also simply raising the question as to whether Richard’s and Charles’s outcomes
might have been less dismal had they not been incarcerated for much of the last three decades in
state hospital environments, Kanner posed what must have been a very dangerous, and
unwelcome, rhetorical question for behaviorists: what if their behaviorist technologies were not
the only (nor arguably, even, the best) possible approach to yield favorable adult outcomes for
autistic children? And they also must have experienced (I imagine, I hope) some sense of
discomfort or at very least dissonance in recognizing that much of the market for their behavioral
technologies continued to be segregated, institutionalized facilities, whether they be residential or
“educational,” “rehabilitative,” or “therapeutic.” Their wireless shockers and other mechanical
technological products continued to be marketed to such facilities, and they continued to
prognosticate to parents on the likelihood and even the beneficence of their children being
committed to institutional facilities, just described by Kanner (1971) as “tantamount to a life
sentence” (p. 144). Clearly the rhetorical limits imposed upon behaviorism by the strategic
coupling of ABA discourse with the etiological narrative of neurobiological defect, and also the
economic limits imposed by ABA’s vestigial coupling with the extant economic infrastructure of
segregated state institutions, together presaged a challenging road ahead for the scaling up of the
early foundations of the AIC that had been laid in the previous decade.
Fortunately for the ABA industry, Lovaas, like Skinner before him, was a masterful
rhetorician, brander, marketer, and, ultimately, businessperson. Following the publication of
Kanner’s (1971) follow-up study and Lovaas et al.’s own (1973) study, which seemed to
highlight the methodological limitations of a laboratory/institutionally based ABA program,
Lovaas set about the business of reframing, and ultimately rebranding, his research. As an
illustration of the decisive success of this rebranding initiative launched in the late 1980s and
early 1990s (and hinging upon the two rhetorical moments previously identified), I’ll briefly
compare the rebranded vision of hope on offer in operant behaviorism at this time with the
extant, earlier brand, by contrasting two autobiographical narratives written by parents of autistic
children, each seeking operant behavioral intervention and treatment for their children, both
under the guidance of the same behaviorist clinician (Lovaas), two decades apart. Ironically, the
first parent, consuming the very cautious and tepid brand of hope on offer in behaviorist
discourse in the 1970s, is the father of a son who participated in the very study later reported
upon by Lovaas in 1987. And the second parent was a consumer of that rebranded vision of hope
(“recovery”) that Lovaas offered in 1987, which she subsequently amplified, magnified, and
disseminated even more widely by repackaging Lovaas’s rebranded hope in an even more
readily- and widely-consumed format: that of a beautifully written memoir that soon found its
place at the top of the New York Times bestseller list.

Consuming (Rebranded) Hope: Hope (Behaviorist-Style), Mark Two

Throughout the decades of the 1950s, ‘60s, ‘70s, and beyond, parents of autistic children
consistently reported struggling with the inherent tensions between their own hopes for their
child and the often dire prognoses offered by professional, “expert” discourses on autism and
disability (Bérubé, 1996; Biklen, 1992; Park, 1967). One of these parents’ hopes for a brighter
future for his son led him to seek out the work of O. I. Lovaas at UCLA’s Young Autism Project.
Greenfeld (1972), a parent of a young autistic son, shares his alternating hopes for and his fears
of his son’s possible futures, and he describes an ever-present sense of urgency about action: “I
still don’t know what to do—I only know I must do whatever I possibly can” (p. 92). Greenfeld
describes this sense of urgency about action, his desire to “do” something for his son against the
backgrounds of “the very real possibility of his eventual institutionalization,” (p. 93) and of his
understanding that there is something “profoundly wrong with” (p. 92) his son. Greenfeld also
poignantly attests to “the indomitability of my hope (he will mature, he will outgrow what is
wrong)” (p. 63).
In the early 1970s, Greenfeld’s desire to act in support of his son is not met with a very
hopeful professional discourse on intervention. When Noah Greenfeld was accepted into
Lovaas’s YAP for behavioral therapy in 1970, Greenfeld (1972) notes that “Lovaas himself told
me: ‘I promise no miracles, I hold out little hope’” (p. 120). In describing what he hoped his son
would gain from the behavioral therapy, Greenfeld says,

the idea is simply to be able to control Noah, to make him a robot, if possible, in terms of socially acceptable behavior.
For if we can’t control him, or get him to control himself, we’ll have to let him go.” (p. 170)

Though Greenfeld does not relish the thought of turning his son into a “robot,” he maintains this
goal as his hope for his son in contrast to the unthinkable alternative: “let[ting] him go,”
presumably alluding to the possibility of institutionalizing Noah. He later writes, “I spoke to
Lovaas again. He was pessimistic, reminded me that only one in twenty autistics really make it
out of their condition” (p. 171). There is little discussion in Greenfeld’s text as to what it may
mean for a person labeled with autism to “really make it out of their condition.” The reader is
merely left with the sense that this particular vision is exceedingly rare (1 chance in 20; five
percent), and is not to be realistically hoped for.
More recently, Maurice (1993) wrote an autobiographical account of her use of ABA
treatment with her own children entitled Let Me Hear Your Voice: A Family’s Triumph over
Autism. Maurice, the parent of two young autistic children, chronicles her family’s
implementation of a home-based ABA treatment program modeled after Lovaas’s YAP (the
same project that Greenfeld’s son, Noah, participated in in the 1970s), and the subsequent
“recovery” (Maurice, 1993) of her daughter and son from autism. Maurice’s bestselling
autobiographical text brought Lovaas’s work to the attention of the general public and helped to
bring the language of ABA to the widespread attention of parents of young autistic children.
Both Greenfeld and Maurice acted by pursuing interventions for their children that were
grounded in the principles of operant behavioral conditioning as practiced by the same
behavioral psychologist, O. I. Lovaas, at the University of California, Los Angeles. Though these
parents elected to provide similar models of treatment for their children under the guidance of the
same researcher about 20 years apart, we can note a curious difference in the ways that hope is
constructed in the rhetoric around behavioral intervention when we compare the experience of
the Greenfelds in the 1970s to the experience of the Maurices in the 1990s.
Maurice (1993) embraces a very different vision of hope for her daughter upon making the
decision to pursue a behavioral intervention program modeled after Lovaas’s work. She
describes a relative calling her and telling her about an article she’d read:

“about a Dr. Lovaas, at UCLA. It says he’s recovering some kids from autism . . .” Recovering some kids from autism?
No one we were talking to had mentioned the word recovery. Could this be true? . . . The results were unprecedented.
Almost half (nine out of nineteen) of the children in the experimental program had achieved “normal cognitive
functioning.” . . . But were they truly recovered? (p. 61–62)

Maurice reports her initial doubts about the possibility of “truly” recovering children from
autism and also shares with readers her initial distaste at the thought of behavioral therapy:

On the face of it, the idea was nothing short of appalling to us . . . . Already, I didn’t like behavior modification, and I had
yet to go through Anne-Marie’s first sessions. Nevertheless, if someone was recovering kids with behavior modification,
we had better look into it seriously. (p. 63)
However, even in the face of her initial distaste with the thought of using behavior modification
as an intervention method and her initial doubts as to whether the children she’d read about were
“truly recovered,” Maurice and her husband pressed on and pursued an intervention program
based on Lovaas’s ABA model, setting up an intensive home treatment program for her
daughter, compelled by what she calls “this doorway to hope” (p. 65)—the possibility that
“someone was recovering kids with behavior modification.” She writes of the significance of this
vision of hope to her decision to act as she did on her daughter’s behalf:

It took us a few days to begin to say the word “recovery” aloud, to begin to talk about it. It seemed impossible, given
everything we had read and heard. Dared we raise our hopes? . . . Once we had adjusted to hope, there was no turning
back . . . the goal was there. It had become real and possible. We set our sights for the mountaintops, the very stars. Anne-
Marie would be whole and normal. She would talk and smile and grow and love. She would recover. (pp. 65, 67)

Maurice’s vision of hope for her daughter, of “recovery,” of “be[ing] whole and normal,” stands
in rather stark relief against Greenfeld’s hope “to be able to control Noah,” to “make him a robot
. . . in terms of socially acceptable behavior.” Additionally, the possibility of Maurice’s vision of
hope being realized would appear to be much more favorable (“almost half”) than Greenfeld’s
vision (“only one in twenty”). How might it be that the visions of hope and possibility espoused
in operant behaviorist discourses around autism have changed so radically over the relatively
short span of 20 years? How did the hope for robotlike “control” of a child to stave off his
institutionalization become the hope for a similar child’s “recovery” from autism?
It is difficult to overestimate the rhetorical significance of Lovaas’s construct of “recovery [to
normalcy]” from autism in the post-1987 rebranding of hope within ABA discourse. It is also
difficult to overestimate the extent to which both the meaning and the success of this rebranding
campaign are entirely dependent upon both the ideological products and the economic
architecture of the AIC. As will become evident in Chapter Four, the deployment of the construct
of recovery in this context both relies upon and also reinscribes the central ideological
architecture of the AIC, successfully advancing a conceptual apparatus in which (a) the
ontological category of autism is constituted as hopeless and culturally devalued and (b) the
cultural logic of the necessity of intervention as the only source of hope in relation to autism is
cast as a hegemonic background assumption. To reiterate, not everyone ultimately consumes
autism intervention services; however, one’s market share will undoubtedly be increased if
future potential consumers of autism intervention services have already been integrated into
unquestioning consumption of these foundational ideological products of the AIC.
It will also become evident that an integral element of this rebranding effort included from
the very beginning an explicit economic analysis as a primary argument for the consumption of
ABA intervention services. In that first watershed rhetorical moment—Lovaas’s (1987)
rebranding of hope as hope for “recovery”—he concluded his article by explicitly invoking a
cost–benefit analysis of the potential outcomes of using versus not using behavioral treatment:
“The assignment of one full-time special-education teacher for 2 years would cost an estimated
$40,000, in contrast to the nearly $2 million incurred (in direct costs alone) by each client
requiring life-long institutionalization” (p. 9). It is clear that this rebranding initiative was
launched squarely within the historical and cultural background context of the neoliberal
economics of the Reagan era, complete with the potential specter of austerity policies looming
large. Not only was this intervention product argued to be effective in this initiative, it was also
argued to be efficient, from a simple return-on-investment economic perspective. And unlike
Lovaas’s earlier unequivocal claim that “the program does not turn out normal children, and
should a child become normal as we treat him, then that no doubt, is based on the fact that he had
a lot going for him when he first started treatment” (Park, 1971, p. 39, cited in Cohen, 1998, p.
82), in the 1987 rebranding he rhetorically crafts the manuscript to repeatedly make or imply the
exact opposite claim: that children do “recover” (i.e., normal children are turned out), and
moreover that that recovery to normalcy is a direct result of the behavioral technologies his team
deployed in the treatment-effect study. And not merely 5% of the time—nearly 50%. That’s
quite a rebrand.
It had become clear by the mid-1970s that ABA had a significant branding problem that this
publication (Lovaas, 1987) sought to redress. Indeed, as already noted, at the outset of her
memoir, itself the second watershed rhetorical moment in ABA’s rebranding campaign, Maurice
described the idea of using ABA intervention with her children as “nothing short of appalling to
us” (p. 63). By beginning with the admission that the prospect of ABA was not merely
distasteful, but “nothing short of appalling,” Maurice sets the stage and the purpose for the
second watershed moment of ABA’s rebranding effort that her memoir so masterfully performs.
To the extent that nonautistic parents are the consumers/authorizers (even if funded by public
dollars) of ABA interventions, it is important that they not only are not appalled by it, but that
they actually desire it, actively seek it out, and, ultimately, trust it. Maurice’s memoir, building
upon Lovaas’s treatment-effect study, aimed to do (and succeeded in doing) all three: desire for
ABA intervention for one’s autistic children was successfully groomed through the rhetorical
deployment of the construct of recovery [to normalcy]. Parents sought out and demanded this
treatment largely through the popularization of these ideas that Maurice’s memoir launched and
which subsequent media coverage fueled and maintained (because how many parents read
published reports of treatment-effect studies in academic journals, anyway?). And as a parent
herself, Maurice was perhaps best positioned to deploy the powerful tactic of invoking the
discourse of positivist science to ultimately brand trust in ABA interventions.
O. I. Lovaas died on August 2, 2010, at the age of 83. In a Los Angeles Times news article
reporting on Lovaas’s death, it was noted that “He described some of his research subjects as
having ‘recovered,’ a concept that remains controversial but appealed to parents and helped
launch an industry that provides the treatment to the growing numbers of children being
diagnosed” (Zarembo, 2010, n.p.). The author incisively notes the crux of Lovaas’s rhetorical
legacy: crafting a rhetorical construct (“recovery”) with wide popular appeal (especially to
parents), the appeal of which forms the rhetorical basis for a lucrative intervention industry
(ABA). Indeed, Lovaas’s most enduring legacy is not his science, it is his rhetoric. His 1987
rhetorical construction of the notion of “recovery [to normalcy]” continues to appeal powerfully
to parents and family members and educators and legislators and journalists and academics, and
even to some autistic people, all of whom are immersed in a culture wherein normalcy is highly
and unquestionably valued and relentlessly pursued through a wide range of “interventions,”
while an autistic identity continues to be rhetorically devalued and stigmatized, carrying the
cultural baggage of disorder, damage, defect, deficit, disease, alien, invader, enemy (Broderick,
2010).
Recall that neoliberalism “operates not only as an economic system, but as a political and
cultural system as well” (McChesney, 1998, p. 9), and that the various components of an
industrial complex seek not only to promote their products and services in order to generate
profit, but also (and perhaps more importantly) seek to promote their ideologies and beliefs,
which are themselves foundational necessities for profit generation in the first place (Picciano &
Spring, 2012). Thus, the profits of the autism industry scaled up once the rhetorical and
ideological architecture of the AIC had successfully done the same.
 Chapter Four offers a detailed analysis of the careful, deliberate, and skillful deployment of
this specific rebranded vision of hope in ABA discourse (“recovery” from autism). Chapter Five
offers a similarly detailed analysis of the deployment of the rhetoric of “science” in these
rebranding efforts, particularly in marketing the new brand to a general popular audience of
parents and potential parents. Both of these concepts facilitated (and continue to facilitate) the
widespread and large-scale consumption of the AIC’s foundational products: (a) the ontological
category of autism as a social problem, and (b) the cultural logic of intervention as its
institutional response, thus propping up and institutionalizing the autism intervention industry.
These tactics, coupled with the widespread media deployment of cultural fearmongering about
autism (see Chapter Six) served to facilitate the enshrinement of this conceptual apparatus in
policy and law and thereby to create the conditions necessary for the economic infrastructure of
the AIC to be forged. By so effectively grooming (a) a widespread market for ABA intervention,
(b) willing (even demanding) consumers of that intervention, and (c) a high degree of consumer
confidence in the intervention services demanded, this powerful and almost unimaginably
successful rebranding campaign also paved the way for the rapid and widespread scaling up of
the autism industry itself, fueling a boom manifest in the proliferation of its myriad (e.g.,
intervention, diagnostic, prevention, kitsch, etc.) autism industries that others have since
documented and described (e.g., McGuire, 2016; Grinker, 2020).

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CHAPTER FOUR

The Politics of Hope:

Autism and “Recovery [to Normalcy]”
A previous version of this chapter was published (2009) in the Journal of Intellectual and Developmental Disabilities under the
title “Autism, ‘recovery [to normalcy],’ and the politics of hope.” Parts of that essay are reprinted here with permission.

A CENTRAL FEATURE OF applied behavior analysis (ABA) discourse and rhetoric on autism from
1987 through the turn of the century, and one that lingers and endures to this day, has been
the construct of “recovery” from autism. This rhetorical construct was taken up in many spheres
—from academic literature in the disciplines of education, psychology, and law (Cohen, 1998;
Gresham & MacMillan, 1997; Jacobson et al., 1998; Kotler, 1994; Mulick, 1999), to parent and
autobiographical narratives (Barron & Barron, 1992; Grandin & Scariano, 1986; Johnson &
Crowder, 1994; Kaufman, 1994; Maurice, 1993; Stehli, 1991), to popular and electronic media
(Fanlight Productions, 1998; Kirkus Reviews, 1993; Kirsch, 1993; Sege, 1993; van den
Nieuwenhof, 1996; Weizel, 1995; Wolfe, 1993), to the kitchen table and listserv and social
media conversations of parents of young autistic children. Recovery is a viscerally powerful
construct, one that is intimately connected to conceptualizations of hope and one that many
parents draw on in articulating their hopes for their own autistic child. During the course of a
previous qualitative study (Broderick, 2004), when I asked a parent, Carmen [a pseudonym],
why she and her spouse were using ABA interventions with their young son, she looked at me
rather quizzically and replied, “It’s the only thing that’s been scientifically proven to work in
recovering kids with autism—why would we do anything else?” (p. 1). I was and I remain
compelled by her query. When I asked her what her goals were for her son, Carmen replied, “I
don’t want him to be handicapped—abnormal. I guess my goal for him is recovery, or at least
partial recovery” (p. 131).
During this time, this construct of recovery held a significant place in ABA discourse around
autism, and its relationship to constructs of hope was integral to the burgeoning popularity of
behavioral intervention—i.e., it was an integral component of ABA’s rebranding campaign. As
Cohen (1998) and others have acknowledged, the parameters of the institutional discourse
around ABA and hope for recovery from autism were largely constituted by the writings of O.
Ivar Lovaas (1987) and Catherine Maurice (1993) in her autobiographical account of her own
children’s so-called recovery using Lovaas’s methods. Though Lovaas set the stage by
introducing the rhetorical construct of recovery to ABA discourse in his treatment effect study,
the construct was popularized with parents and inextricably linked with hope by Maurice’s
memoir and the frenetic public discourse that ensued following the publication of her
autobiographical account of the recovery of her two young children from autism.
It is not difficult to imagine that an intervention discourse so clearly predicated on a bold
rhetorical vision of hope might be highly attractive to parents of young autistic children, standing
as it would in such stark contrast to the relative sense of hopelessness that has historically
characterized much of the discourse around autism for well over half a century. Indeed, I argue
that the intensification of interest in the behavioral discourse on autism that took off in the early
1990s may be at least partially understood by examining its active engagement with a
particularly bold and compelling vision of hope—the construct of recovery from autism—and
the powerful resonance that concept may have with parents’ hopes for their children. And that
compelling vision of hope operated as an inducement to the eager and widespread consumption
of autism as an ontological category and the cultural logic of (behavioral) intervention in relation
to it. The conceptual apparatus narratively offering “recovery” from autism was thus rolled out
and scaled up as a carefully crafted branding and marketing campaign, skillfully deploying the
cultural politics of hope in grooming parents of autistic children to become consumers of ABA
intervention.
In the process of conducting in-depth interviews with parents who agreed to participate in the
original study, I quickly realized that most of the parents drew on a common set of ABA-related
constructs in their descriptions of their experiences and that parents regarded and presented these
constructs as if they were merely mirroring some objective and taken-for-granted aspect of the
world. Each of the parents referred to the texts selected for inclusion in this analysis by asking
me questions such as, “Have you read the Maurice book?,” “You’ve heard of Lovaas’s study,
right?,” or “So do you believe recovery is possible?” The ways that parents constructed and
constituted ABA and the notion of recovery in their own talk was, thus, integrally informed by
and derived from the ways those very concepts had been produced and circulated for
consumption in ABA texts and in the popular media; it is these texts and their rhetoric that I treat
as qualitative data in this analysis.

Recovery and Positivism—Framing Prior Inquiry

Maurice (1993), when first encountering the construct of recovery from autism, asked herself,
“Could this be true? . . . But were they truly recovered?” (pp. 61–62). Similarly, Cohen (1998)
asked, “Is recovery from autism really possible?” (p. 79). Indeed, in Lovaas’s (1987) article, he
pointed out that he used the term normal functioning to describe “children who successfully
passed normal first grade and achieved an average IQ on the WISC-R [Wechsler Intelligence
Scale for Children—Revised; Wechsler, 1974]” (p. 8). Lovaas then stated that “questions can be
asked about whether these children truly recovered from autism” (p. 8). Cohen (1998) has also
suggested that “before the question of recovery can be examined productively, an operational
definition has to be specified” (p. 160). Thus, much of the discussion and dissent around the
construct of recovery from autism in the literature throughout the 1990s and much of the first
decade of this century have been framed in these terms, suggesting that the significance of the
construct lies in the expert determination as to whether recovery from autism in general is really,
truly, verifiably, objectively possible or whether particular individuals might really, truly, validly
be classified as recovered.
The assumptions underlying the framing of such questions would suggest that the “question
of recovery” is one that can be instrumentally addressed by specifying operationally what is
“really” meant by the term and by judging the goodness of fit between the operational definition
and the observed empirical phenomenon in reference. These questions have thus been
conceptualized from within a positivist worldview. They are framed largely as objectivist
questions of whether the language—the specific term recovery—accurately, objectively, and
verifiably reflects the essence and the reality of the phenomenon being observed. For example,
Cohen (1998) asked, “Are these individuals recovered, or are they autistics with near-normal
functioning?” (p. 170), with the implicit assumption that there is a meaningful, real distinction
between recovered individuals and “autistics with near-normal functioning” and that only one of
these two ways of talking about these referenced individuals accurately reflects and represents an
underlying empirical reality.
It is vastly less interesting to me to consider whether these “recoveries” were real or true,
and vastly more interesting to ask what the rhetoric of recovery does or accomplishes. That is, in
keeping with Dolmage (2018), I share a rhetorician’s interest in “how language is used to
persuade” and, moreover, in the ways that rhetoric shapes beliefs and actions. I therefore
“foreground the persuasive potential of all texts and artifacts, linking language to power,” and
remind the reader that sometimes “the ways that messages are shaped, delivered, repeated, and
recirculated can be just as important as their veracity, facticity, or truthfulness” (p. 2). Perhaps,
sometimes, even more important. How were messages about “recovery” (and therefore, about
autism and the cultural logic of intervention) shaped, delivered, repeated, recirculated, and
consumed during the late 1980s and 1990s? In what ways was the rhetoric of recovery deployed
as a branding and marketing tool—as an inducement to consumption of the interventionist logics
and products and services on offer in the autism marketplace?

Recovery and Hope in ABA Discourse

Maurice’s (1993) memoir was widely read and critically acclaimed for its contribution to the
literature on early intervention for young autistic children and in particular, on ABA as an
intervention method. When the book was published, reviewers were largely positive in their
reviews, enticing readers with promises of:

A vivid and uplifting story of how a family pulled not one but two children out of the torments of autism—and into a
normal life . . . this [book] offers not only hope but a road map . . . . Maurice offers new strength to parents who refuse to
give up on their autistic children. (Kirkus Reviews, 1993, n.p.)

Another reviewer wrote:

A word seldom heard in discussions of autistic children is “hope.” A word even more rare is “recovery.” Both are
possible, however, if children receive early “behavior modification” treatment from therapists and patient, persistent
training from parents, argues Catherine Maurice . . . . Finally, Maurice learned of one area of research offering real hope.
(Wolfe, 1993, p. 14a)

Yet another reviewer lauded Maurice’s text as a “universal tale of hope, dogged parental love,
hard work and ultimate triumph” (Sege, 1993, p. 27). Acknowledging some of the controversy
surrounding debates over treatment approaches for young children with labels of autism, another
reviewer presented Maurice’s (1993) endorsement of ABA as “a convincing argument,” and
asked readers, “after all, who is a more credible advocate than a mother whose children were
redeemed from the ‘death in life’ that is autism?” (Kirsch, 1993).
The Maurices’ (1993) story was, thus, described as a “universal tale of hope” in which both
[hope and recovery] are possible.” In addition, the family was described as having found “real
hope,” in implied contradistinction to unrealistic or false hope. Perhaps most eye catching to a
parental audience reviewing this text was the offering of “not only hope but a road map.” The
inside front cover of Maurice’s book reads, in part:

This is the profoundly moving story, told by their mother, of how two children were rescued from the tragedy of autism—
and the first account in which diagnosis, therapy, and authentic recovery are fully documented . . . . Diagnosis: autism.
Prognosis: incurable. We follow their frantic search for anyone who might offer hope—a search that leads . . . finally, [to]
their providential discovery of the work of O. Ivar Lovaas, who, using intensive behavioral therapy with very young
children, had achieved a documented recovery rate of 47 percent—children who are now teenagers and are cognitively
and socially normal. (Maurice 1993, n.p.)

Many parents who pursued ABA-based treatment interventions with their young children
have reported that Maurice’s (1993) book was one of the most influential texts they read after
being given a diagnosis of autism for their child, one that prompted them to seek out similar
interventions for their own child. In a 1998 Canadian Broadcasting Company documentary
entitled Behind the Glass Door: Hannah’s Story (Fanlight Productions, 1998), a grandmother of
a young autistic child described how Maurice’s book led her family to seek out ABA
intervention for her granddaughter:

I found the book, Let Me Hear Your Voice—I think I got it out of the library. And I read it, and the more I read, the more
encouraged I got, and I thought, “this lady has really worked with her child,” and this can happen, this can happen for
Hannah.

Hannah’s mother, Karen Shepherd, said of reading Maurice’s book, “It was like hope was
reborn.” Shepherd describes in the video how she came to pursue for her daughter the ABA
intervention that was described in Maurice’s book:

I heard about Durham Behavior Management, and I heard that they would help people with autistic children. And I can
remember with fear and trembling, I had this book in my hand, and I walked into their office and made an appointment,
and I said, “Have you read this book? I want to do this with my daughter—will you help me?”

Listening to parents describe the tedious and often disheartening process of sifting through
vast amounts of information on autism and intervention, their descriptions of Maurice’s (1993)
text are often strikingly similar in that many parents described this book as providing a much-
needed sense of hope for their child:

The Pagonis say they don’t feel helpless anymore. They gained hope after reading a book by another Connecticut woman,
who wrote under the pseudonym Catherine Maurice, that chronicles what she describes as the recovery from autism of her
two young daughters [sic] after treatment with an intensive behavioral method. (Weizel, 1995, p. 15)

Other parents have echoed similar sentiments in sharing their stories:

What the Taylors found most distressing was that they were not offered any hope for their son. Rather, they faced the
prospect of him never being able to lead an independent life. Then a friend discovered an article about a woman who had
apparently helped her autistic daughter to make a full recovery by using the Lovaas method of healing . . . . [T]o the
Taylors, it represented their only hope of bringing their son back from the mysterious world into which he had retreated . .
. . “We felt we owed it to Oliver to try absolutely anything that offered him a chance of recovery.” (van den Nieuwenhof,
1996, n.p.)

In many ways, Maurice’s (1993) text thus served as a vehicle for the popular consumption of the
rhetorical construction of hope for recovery from autism. The particular vision of hope that was
shaped, delivered, repeated, and recirculated in the consumption of this rhetoric had at least two
related conceptual elements: (a) hope for recovery within ABA discourse is constructed in binary
opposition to hopelessness, and (b) recovery within ABA discourse is discursively constructed as
“recovery [to normalcy].”

Hope for Recovery Versus Hopelessness

Within this rhetorical narrative, hope for recovery is discursively constructed in binary
opposition to hopelessness: one is presented with a perceived choice between hope and despair.
This rhetorical opposition of hope and despair in a sense disciplines the hopes of parents,
educators, and policymakers in envisioning and enacting possible futures for young autistic
children. I argue that three interrelated elements of this opposition of hope versus hopelessness
contribute to the disciplinary power of this conceptual binary and to the ways that it operates as
if natural, neutral, and commonsensical (i.e., hegemonic). This binary conceptualization of hope
versus hopelessness disciplines the conversation around hope and recovery by (a) rhetorically
representing autism (specifically) and disability (generally) as inherently tragic, catastrophic, and
hopeless; (b) representing hope for recovery not as a vision of hope but as the only vision of
hope for a young child labeled with autism; and (c) inextricably linking this “only” hope (for
recovery, the desired end) with a specific intervention methodology, ABA, as the means
necessary to attain that end. And the consumption of the first two elements facilitates
consumption of the third (which undergirds the economic architecture of the AIC).

Autism/Disability as Tragic, Catastrophic, and Hopeless

It would be difficult to characterize professional discourse on autism in the late 1980s or early
1990s as having been particularly hopeful. Autism discourse at that time typically maintained the
decades-long belief, propagated initially by Rimland (1991), that 50%–75% of autistic people
were intellectually disabled (Freeman, 1997; Rapin, 1997; Rutter, 1978, 1983) and that potential
futures for these individuals often included the possibility of institutionalization (Lovaas, 1987,
1988; Ornitz & Ritvo, 1976; Rutter, 1970). Maurice (1993) described her encounters with these
discourses, pointing out that “everything I read [about autism] was so appalling, and spelled such
hopelessness” (p. 22). Shortly after being given a diagnosis of autism for her daughter and
having read what information she could find on the subject, Maurice said, “What we already
knew, sitting in Dr. DeCarlo’s office, was that autism was considered to be a permanent
handicap, and that our daughter, according to prevailing medical opinion, would never talk, or
act, or love in any normal way” (p. 26). Thus, Maurice’s understanding of autism at that point
was constructed as similar to permanent exclusion from normal participation in talking, loving,
and other actions and aspects of everyday life.
The inside cover of Maurice’s text sums up a common popular and professional perception at
the time of the relationship between the label of autism and the possibility of hope: “Diagnosis:
autism. Prognosis: incurable.” Many other parents have reported similar prognoses of doom over
the decades; for example, Kaufman (1994) shared the story of the prognosis offered for his son
that, unfortunately, would be all too familiar to many parents:

The clinician now looked at us rather sadly and tried to convince us of the unfortunate prognosis for this condition. His
associate suggested that we were lucky to have two normal children. In effect, he said, we should focus our attention on
them and consider eventual institutionalization for our son. Never, ever, did we want to see our child through their eyes . .
. . We decided to be hopeful even if others called such a perspective unrealistic. Without hope, we had no reason to go on.
(pp. 24–25)

This common popular and professional conceptualization of autism as equivalent to hopelessness

was not unique to ABA discourse, nor is it to this day a concept that may safely be described as
long outdated. Nevertheless, this background constituted integral context for the aggressive
branding and marketing campaign of ABA as representing a distinct and spectacular vision of
hope in relation to the construct of autism.
Central to this rhetorical vision of recovery as hope in opposition to despair is the
understanding and representation of autism as utterly and totally catastrophic, a tragic condition
devoid of hope by its very essence. Maurice (1993) described the despair that autism represented
to her:

There is something about autism that to me gave meaning to the phrase “death in life.” Autism is an impossible condition
of being there and not being there; a person without a self; a life without a soul. (p. 57)

Reviewers similarly framed this “impossible condition” as tragic when they described Maurice
pulling her children “out of the torments of autism” (Kirkus Reviews, 1993, n.p.), and of their
being “rescued from the tragedy of autism.” Maurice recounted the dominant professional vision
of autism as a tragic disability with a dire prognosis when she reported to her readers what she
had learned from her own reading on the subject:

As to prognosis, over half the children had a “uniformly poor prognosis” and only about a quarter of them could do
“moderately well,” whatever that means. Any mention of “cure” or “recovery” was conspicuously, ominously, absent. (p.
17)

Lovaas himself (1987) had also contributed to this construction of autism as a disability with
little room for hopeful visions of a child’s future by opening his manuscript in this way:

Autism is a serious psychological disorder with onset in early childhood . . . . The prognosis is very poor . . . . The
majority [of individuals in Rutter’s (1970) follow-up study] (more than 60%) remained severely handicapped and were
living in hospitals for mentally retarded or psychotic individuals or in other protective settings. (p. 3)

And he similarly closed his manuscript with the rhetorical juxtapositioning of the hope he was
offering (of potential “recovery”) in opposition to a vision of hopelessness and despair. Recall
the cost-benefit analysis with which he concluded his manuscript—he asked the reader to weigh
the cost of his early intervention program against the “nearly $2 million incurred (in direct costs
alone) by each client requiring lifelong institutionalization” (p. 9). Lovaas thus rhetorically
presented his construction of the possibility of hope for recovery through behavioral intervention
against the background of the possibility (or even probability) of “lifelong institutionalization” of
one’s child, a prospect that may indeed epitomize hopelessness for many parents.

Hope for Recovery as the Only Vision of Hope

A second conceptual element of this binary construction of hope versus hopelessness was the
representation of hope for recovery not as a vision of hope for young autistic children but rather
as the only vision of hope for them. In the context of the ongoing messaging in ABA rhetoric of
the first element of this conceptual dichotomy—the representation of autism as inherently tragic,
catastrophic, and hopeless—the concept of hope for recovery stood in stark contrast to this
dominant picture of hopelessness and despair and was presented as the only hopeful vision
available, or at least, as the only real hope. Recovery thus became almost synonymous with hope
itself—in the apparent absence of any other visions of hope, hope for recovery was welcomed
and embraced by those who long for a hopeful—any hopeful—vision of a future for their young
autistic child, in spite of the dire prognoses predominantly on offer.
 The experience of the Taylor family described earlier testifies that what was most distressing
for them was that “they were not offered any hope for their son. Rather, they faced the prospect
of him never being able to lead an independent life” (van den Nieuwenhof, 1996, n.p.). After
learning of Maurice’s (1993) experience, who had “apparently helped her autistic daughter to
make a full recovery by using the Lovaas (1987) method of healing” (van den Nieuwenhof,
1996, n.p.), they, too, began an ABA program modeled after Lovaas’s program, because, “to the
Taylors, it represented their only hope of bringing their son back” (van den Nieuwenhof, 1996,
n.p.). This family felt that they were not offered any hope for their son, and in this relative
absence of hope of any kind, the possibility of recovery through “the Lovaas method of healing”
therefore represented to them their only hope for their son.
Maurice (1993) spoke of adjusting to hope following the diagnosis of autism for her daughter
and the accompanying guarded prognosis she had been offered: “And once we had adjusted to
hope, there was no turning back . . . the goal was there . . . Anne-Marie would be whole and
normal. She would talk and smile and grow and love. She would recover” (p. 67). For the
Maurices, as for the Taylors, hope was something they had not had much of following their
daughter’s diagnosis, and it required a shift in their thinking, an adjustment, to dare to hope for
their daughter. As Maurice embraced the idea of entertaining hope—any hope—for her daughter,
that hope was very clearly linked to a particular vision, a particular goal—that she would
recover. In this way, hope for young autistic children became inextricably linked with hope for
recovery in popular ABA (and increasingly, autism) rhetoric. Within the disciplinary confines of
this rhetorical narrative, if one were to embrace hope for one’s child at all (and what parent
would not?), recovery was constructed as the only possible basis for that hope and, thus, became
the desired end, the goal—the vision held out, hoped for, consumed, and subsequently worked
toward.

Linking of Only Hope with ABA

A third conceptual element of this binary construction of hope versus hopelessness was the
explicit linking of this only vision of hope with one particular intervention method: ABA. Once
recovery was constructed in both professional and popular rhetoric as the singular vision of hope
for young autistic children, a vision that was narratively constructed in binary opposition to
institutionalization and despair, one could not help but wonder what parent would not choose to
embrace recovery as their hope for their young child? As Carmen so incisively asked me, “It’s
the only thing that’s been scientifically proven to work in recovering kids with autism—why
would we do anything else?” It appeared to be a self-evident, neutral, commonsense, and
straightforward choice—of course one would choose hope over despair, the possibility of
recovery over the likelihood of institutionalization. It was hardly surprising that parents who
articulated and embraced this particular vision of hope, of recovery, for their son or daughter also
embraced the intervention method, ABA, that was explicitly linked to claims of recovery in this
rhetoric. Why would we do anything else? Why, indeed.
This is neoliberalism operating as an epistemologically and ideologically hegemonic system.
And as McChesney (1998) observed, a keystone of neoliberal ideological architecture is not just
the manufacturing of markets, but crucially, the effective branding of one’s own product in direct
relation to that market, such that marketing rhetoric is most effectively deployed not to position
whatever one is selling as the best alternative, but rather as the only alternative. If autism is
inherently a hopeless condition, if hope for recovery is the only hope that exists, if that singular
vision of hope can only possibly be achieved through one intervention product on the market
(ABA), it is little wonder that business boomed in wake of this powerful messaging campaign.
And if the first element of this conceptualization of hope for recovery in ABA rhetoric was its
construction in binary opposition to hopelessness and despair, the second integral conceptual
element of this conceptualization of hope was its construction of recovery as recovery [to
normalcy].

Recovery [to Normalcy]

Lovaas was not the first to use the rhetorical construct of recovery in relation to autism; however,
he very effectively repurposed and rebranded this construct to have a distinctly different (and
vastly more rhetorically powerful) meaning, and thereafter, commercial purpose. The language
around recovery from autism had been circulating for some few years before Lovaas’s (1987)
usage (see Broderick, 2009 for a detailed review of that literature), primarily in the emergent
genres of biographies and autobiographies of autistic adults. By and large, this extant usage of
the notion of “recovery” centered on the process of increasing participation, involvement, and
success in many ordinary spheres of life, and those individuals that were described as recovered
were largely those for whom the effects of autism were no longer disabling in any significant or
substantially limiting way. Lovaas’s construct of recovery from autism was a qualitatively
different one, one that at first may have appeared to challenge the relevance of the dichotomous
constructs of abled/disabled, autistic/recovered, or normal/abnormal, but that ultimately
reinscribed these dichotomous categories in profoundly conservative ways.
Lovaas and his colleagues (Lovaas, 1971, 1993; Lovaas & Smith, 1989; McEachin et al.,
1993) have repeatedly questioned the validity and the usefulness of the construct of autism.
However, rather than challenging the relevance of these constructs autistic/recovered and the
binary categories of ability/disability or normal/abnormal in which they are grounded, Lovaas’s
(1987) rhetoric of recovery sought to challenge the position, the permeability, and indeed the
permanence, of the line that delimits one category from the other while apparently maintaining a
commitment to the usefulness and veracity of the binary categories themselves (despite having
previously questioned their validity or usefulness). Far from critiquing or deconstructing
ability/disability or autism/normalcy (the latter a nonparallel binary juxtaposition, I might point
out), the rhetoric of recovery from autism in ABA discourse served, rather, to reinscribe the
legitimacy and apparent neutrality of these categories, relying as they did on a conservative
ideological privileging of normalcy, as illustrated in the following quote. Cohen (1998) pointed
to the crux of this difference when she observed,
That word “recovery,” the rallying cry of parents of young children with autism who believe in Lovaas and Catherine
Maurice, a word otherwise unheard in relation to autism, is a word with an implied promise: normalcy. Your child can be
normal. (pp. 158–159)

Recovery, within ABA rhetoric, was not about “fitting smoothly into settings of normal people”
(Rimland, 1991, p. 223), as Rimland several years later suggested about Temple Grandin when
he described her as “recovered,” a usage that similarly relied on the maintenance of a
fundamental division between normal and abnormal. It was, rather, as Cohen (1998) suggested,
constructed as being about “be[ing] normal” (italics added, p. 159). Thus, in ABA rhetoric at the
time, the construct of recovery seemed to carry the implicit object of recovery [to normalcy] as a
basis of hope for young autistic children. How, precisely, did the construct of recovery come to
be so closely linked with the construct of normalcy within ABA discourse, specifically? Next I
offer a detailed analysis of Lovaas’s (1987) original use of the term recovery and the ways that
he rhetorically constructed the term in the article reporting on his treatment-effect study.

Lovaas’s (1987) Use of the Term Recovery

The rhetoric of recovery from autism popularized by Maurice’s (1993) text is rooted in the
rhetorical construct put forth by Lovaas (1987) in reporting outcomes for the UCLA Young
Autism Project (YAP). Lovaas used the term recovery several times throughout the article, but
he never explicitly defined its meaning as he used it. Twice, Lovaas directly referred to those
children from the experimental group who achieved positive outcomes as recovered (“the
recovered children,” p. 8; and “recovered” as a column heading representing the 47% “best
outcome” children in Table 3, p. 7), and it is in this article—a rhetorical masterpiece—that we
see the rhetorical roots of the association of recovery with normalcy and of the branding of ABA
in relation to that claim.
Although Lovaas never explicitly equated his use of the phrase “normal educational and
intellectual functioning” (p. 3) with his use of the term recovery, the two examples just noted
coupled with his careful use of the term throughout the rest of the article make that clear
implication. In the abstract to Lovaas’s (1987) study, he stated that
Follow-up data . . . showed that 47% achieved normal intellectual and educational functioning, with normal-range IQ
scores and successful first grade performance in public schools. Another 40% were mildly retarded and assigned to
special classes for the language delayed, and only 10% were profoundly retarded and assigned to classes for the
autistic/retarded. (p. 3)

Thus, although Lovaas was later to suggest that the results of this study may have made the
constructs of autism and intelligence superfluous (McEachin et al., 1993, p. 625), he nevertheless
relied heavily on traditional psychological constructs of intelligence in describing the results of
this study. Lovaas carefully used the behavioral terminology of normal functioning to describe
the group of children who achieved best outcome, yet he alternately referred to this best-outcome
group of children as recovered, thus repeatedly making an implicit semantic link between his use
of the construct of recovery and the construct of normalcy.
Interestingly, Lovaas (1987) used no such caution in referring to the remaining 50% of
children who did not achieve best outcome. These children were not cautiously described as
“functioning as mentally retarded”; rather, they were described as being “mentally retarded.” The
metaphoric label of “mental retardation” (Biklen, 2000) was applied to this group of children as
if it described a defining feature of their identity. Similarly, by sliding from the use of the careful
terminology of normal functioning to the more provocative use of the term recovered, Lovaas
semantically moved from an operational term to one that also seemed to describe a defining
feature of the children’s identities. Thus, an equation is rhetorically constructed between
functioning normally and being recovered. To function normally is to be recovered; to be
recovered is to be normal. One might argue that this is something of a semantic leap, although I
contend it is a small one if at all, particularly given the similar leap that Lovaas himself glossed
through in his descriptions of the children who were not in the best-outcome group. The children
who scored—that is, functioned—in the range ascribed to “mental retardation” were not
represented as functioning as “mentally retarded” but were represented as being “mentally
retarded.” This would appear then, to be a semantic leap that Lovaas himself felt comfortable in
making. If the children who functioned in the range of “mental retardation” were “mentally
retarded,” then one might reasonably infer that the children who functioned in the range of
normalcy were “normal.”
 Lovaas (1987) began his article by summarizing the positive and negative points of
experimental behavioral research on children labeled with autism. In summarizing the negative
points of empirical research conducted prior to his present study, he stated, “Treatment gains
have been specific to the particular environment in which the client was treated, substantial
relapse has been observed at follow-up, and no client has been reported as recovered” (p. 3). The
YAP was specifically designed to address these shortcomings of clinical behavioral research. By
specifically identifying those three shortcomings in the introduction, the author rhetorically
implied an intent to illustrate that his research differed from prior research in three significant
ways: (a) that participants’ treatment gains were maintained across environments because they
were taught across environments (p. 3); (b) that “the achievements of experimental group
subjects have remained stable” (pp. 6–7); and (c) that some of his participants were recovered.
Indeed, the first two claims were explicitly made in the article, whereas the third was made only
obliquely, and addressed implicitly, throughout the article. It was this subtext around recovery
and normalcy that has been taken up so powerfully in the discourse around ABA since the
publication of Lovaas’s (1987) study.
Rather than explicitly defining those children who achieved positive outcomes as recovered,
Lovaas (1987) referred to the remainder of the experimental group as “subjects who did not
recover” (p. 5, emphasis added), thus strengthening his implied equation of “best outcome” with
recovery. In describing the culmination and eventual termination of treatment procedures for the
children involved in the study, Lovaas stated,

All subjects who went on to a normal first grade were reduced in treatment from the 40 hr per week characteristic of the
first 2 years to 10 hr or less per week during kindergarten . . . . Subjects who did not recover in the experimental group
received 40 hr or more per week of one-to-one treatment for more than 6 years (more than 14,000 hr of one-to-one
treatment) with some improvement shown each year but with only one subject recovering. (p. 5)

By referring to “subjects who did not recover” as opposed to reporting on “all subjects who went
on to a normal first grade,” Lovaas again implied that the children who went on to a “normal”
first grade were recovered, without explicitly making that statement or defining his use of the
term, recover. This was the third time in the article that this provocative term was used without
what behavioral researchers would call an operational definition. I do not mean to suggest, as
Cohen (1998) has, that an operational definition of recovery needs to be established. However,
given the epistemological (positivist), methodological (quantitative, experimental, treatment-
effect design), and theoretical (operant behaviorism) grounding of Lovaas’s research, it seems
unlikely that a behavioral researcher would fail to provide an operational definition for such a
provocative description of an outcome. This omission suggests that perhaps the power of the
term recovery lies in its rhetorical, rather than its operational, use.
Lovaas (1987) did acknowledge the potentially problematic usage of the term recovery,
stating that, “The term normal functioning has been used to describe children who successfully
passed normal first grade and achieved an average IQ on the WISC-R. But questions can be
asked about whether these children truly recovered from autism” (p. 8, emphasis in original).
Lovaas (1987) pointed out that “certain residual deficits may remain in the normal functioning
group that cannot be detected by teachers and parents and can only be isolated on closer
psychological assessment, particularly as these children grow older” (p. 8). Thus, the stated basis
for Lovaas’s reservation about the use of the term recovery was the possibility of residual
deficits that may be detected as the children grew older. However, McEachin et al.’s (1993)
follow-up study reported that eight of the best-outcome children “were indistinguishable from
average children on tests of intelligence and adaptive behavior” (p. 359). Thus, the stated source
of Lovaas’s hesitancy in applying the term recovered to these children seems to be rectified, and
these findings would seem to confirm his original implication that the best-outcome children
were recovered.
Other authors have critiqued Lovaas and his colleagues on empirical grounds for their use of
the term recovery with its connotative relationship to the concept of “cure” (e.g., Gresham &
MacMillan, 1997). Lovaas et al. responded by backpedaling somewhat on the use of the specific
term recovery. In their reply to Gresham and MacMillan, Smith and Lovaas (1997) stated,

We wrote that it was unclear whether recovery was an appropriate term to apply to the participants in our project (Lovaas,
1987, p. 8), and we have never even considered cure as a possibility . . . . The use of cure would certainly be unethical
because it would imply falsely that we had identified the cause of the autism displayed by children in the study, and then
removed this cause . . . . Instead of “recovery” or “cure,” we have used either “normal functioning” (referring to
performance in the average range across outcome measures) or “best outcome” (referring to a subgroup that appeared to
have a much more favorable treatment response than other intensively treated children) . . . . On one occasion, we used
“recovered” as a column header in a table (Lovaas, 1987, Table 3). In retrospect, this may have caused unnecessary
confusion (which we regret), but we did not claim recovery or cure. (pp. 203–204, italics in original)

Smith and Lovaas (1997) also asserted that Gresham and MacMillan’s (1997) statement that the
UCLA program “claims to produce ‘recovery’” (p. 186) “verges on slander” (Smith & Lovaas,
1997, p. 203), due to the unethical nature of such a claim. However, in Lovaas’s (1987)
concluding discussion, he remarked,

On the basis of testing to date, the recovered children show no permanent intellectual or behavioral deficits and their
language appears normal, contrary to the position that many have postulated (Rutter, 1974; Churchill, 1978) but consistent
with Kanner’s (1943) position that autistic children possess potentially normal or superior intelligence. (p. 8, emphasis
added)

Following the allusions and rhetorical implications made throughout the rest of the article, the
best-outcome children were finally referred to directly, and unproblematically, as the recovered
children, language that is indeed tantamount to a claim of recovery.
However, the salient issue is not whether Lovaas or other behavioral researchers use the term
recovery (or recovered). Indeed, in wake of several critiques of his use of the term recovery
(Baer, 1993; Gresham & MacMillan, 1997; Mundy, 1993), Lovaas refrained from using such
terminology in subsequent peer reviewed publications (see Smith et al., 1997; Smith & Lovaas,
1998), although he continued to use it in non-peer-reviewed publications, with parents as a likely
audience (and others have continued to draw on the construct of recovery [cf. Kotler, 1994;
Mulick, 1999]). For example, Lovaas wrote, in a foreword to an autobiographical narrative with
a likely audience of parents, rather than professionals (Johnson & Crowder, 1994): “Over the last
few years, there is evidence that some children can be helped to recover” (Lovaas, 1994, p. 7).
An additional example is Lovaas’s (2002) training manual entitled Teaching Individuals with
Developmental Delays: Basic Intervention Techniques, wherein he wrote:

Most parents have gained some information about early and intensive behavioral intervention and may have been led to
believe that 47% of all the children treated with this intervention reach normal educational, emotional, and social
functioning. However, this statistic has been obtained only under the most optimal clinic-based treatment conditions.
Workshop-based treatment is estimated to yield a recovery rate between 10% and 20% provided the workshop leader is
qualified. The recovery outcome for workshops led by persons who are not qualified may not exceed 5%. (p. 25)

The salient issue is that engagement with this rhetorical construct of recovery relies on and
reinscribes particular ideological beliefs about the nature of disability and the constructs of
normal and abnormal. Autism is constructed as a disability, certainly, but one from which one
may recover and gain (or regain) the invisible privilege of the status of normalcy. And O. I.
Lovaas secures his place in history as a master rhetorician.

Maurice (1993): Recovery and Normalcy

If Lovaas’s (1987) rhetorical usage created an implied notion of recovery [to normalcy], we can
easily see how this powerful notion was taken up and further reified in Maurice’s (1993)
autobiographical text. She described her transition from thinking of her own child as normal to
thinking of her as autistic:
Anne-Marie was different, not only from other children but from the little girl we thought we knew. Whom had we
known? We had been thinking of her, in spite of our worries, as a normal child, filled with the needs and desires and even
the pastimes of a normal child . . . . Stripped of our illusions, we found Anne-Marie to be suddenly alien. (p. 31)

The problem was that now “it” was her, it was who she was. She “was” autistic, as someone “is” a man, or a woman, or
short or tall . . . . She did not “have” autism; she was autistic . . . . [N]o longer could we find a self in her. (pp. 45–46)

Maurice described that she “had been thinking of her . . . as a normal child,” but after having a
label of autism applied to her daughter, she began instead to think of and construct Anne-Marie
within the context of that disability label. Within that framework, she came to understand her
prior perception of Anne-Marie as a normal child as an “illusion.” Although Anne-Marie may at
first have been constructed by her parents as normal, she now, understood through the
framework of the construct of autism, was not. Autism became who she was, and the identity
ascribed to her shifted from normal to autistic—disabled, abnormal.
Maurice further reflected on this transition:
One issue that was particularly confusing and distressing for us concerned Anne-Marie’s earlier, seemingly normal period
of development. She had had words. Why had she lost them? Where had they gone? How could she have been normal and
now be abnormal? Didn’t the presence of some language in the past mean that at least the potential to speak was still
there? (p. 50)

Although not explicitly stated, this particular passage in Maurice’s text elicits a query in the
reader’s mind: Anne-Marie “had had words,” but she had “lost them”; she had “been normal,”
but now was “abnormal.” In considering the question, “Didn’t the presence of some language in
the past mean that at least the potential to speak was still there?,” the reader is left to infer a
second, analogous question: “Didn’t the presence of normalcy in the past mean that at least the
potential for normalcy was still there?” This is a provocative consideration, and Maurice alluded
to the powerful nature of the construct of normalcy when she admitted that “the idea of
‘normalcy,’ the parameters of what was considered normal development and behavior, began to
obsess me” (p. 14).
Indeed, the notion of recovery to normalcy may be perceived to be particularly appealing and
practical when applied to young autistic children, many of whom may have already enjoyed the
status accorded to “normal” children and for whom the emergence of particular actions and
characteristics resulted in the subsequent acquisition of a label of autism and a status of
disability, of abnormality. Thus, given that many children are not identified as autistic until they
are 2, 3, or even 4 years of age, the notion of recovery to normalcy in such children in many
ways may resonate with the common experience of many parents that their child used to “be
normal” and now somehow, suddenly, is not. By definition, to recover is to regain possession of
something; in this case, the implication is to regain the status of normalcy previously possessed
or accorded that was somehow lost in the onset and labeling of autism in a young child. This
tacit understanding and use of the term recovery [to normalcy] was largely adopted and
reproduced as dominant rhetorical usage during this time, except for a few ventures into the
aforementioned positivist queries regarding whether it is possible to be, and whether particular
children are, empirically, objectively, verifiably recovered.
However, Kephart (1998), herself a parent of a young autistic child, theorized around her
own experiences with her son’s labeling and educational interventions by deftly posing the
critical questions that others at the time did not:

What, in the end, are you fighting for: Normal? Is normal possible? Can it be defined? Is it best achieved by holing up in
the offices of therapists, in special classrooms, in isolated exercises, in simulating living, while everyday “normal”
happens casually on the other side of the wall? And is normal superior to what the child inherently is, to what he aspires
to, fights to become, every second of his day? (p. 11)

In effect, Kephart named the invisible ideological position of privilege on which the construct of
recovery [to normalcy] tacitly rests, a position that Thomson (1997) designated “the normate” (p.
8).
Kephart’s (1998) question, “What, in the end, are you fighting for? Normal?” (p. 11),
exposed and destabilized the ideological assumption that normalcy is the presumed end that we
are “fighting for,” and the corollary presumption that normal is “superior to what the child
inherently is, to what he aspires to, fights to become, every second of his day” (p. 11). In so
doing, Kephart disrupted the rhetoric around recovery [to normalcy] in ABA discourse and
created spaces for engagement with alternative conceptualizations of hope for young autistic
children, embedded in alternative ideologies, alternative values, and alternative practices. But
Kephart’s voice was not amplified by corporate media; her disruption of ABA discourse was but
a momentary blip in the path to the hegemonic institutionalization of the cultural logic of
intervention that took hold in the 1990s. She invoked no broader cultural discourse or rhetoric of
authority, legitimacy, or truth to bolster her incisive claims. She deployed no broader marketing
or messaging strategy. And thus her rhetorical disruption was largely (and regrettably) forgotten.
By contrast, a reviewer of Maurice’s bestselling memoir comments that “finally, Maurice
learned of one area of research offering real hope” (Wolfe, 1993, emphasis added). If recovery to
normalcy is the “real hope,” then other visions of hope are somehow false or illegitimate. And if
that real hope is instrumentally linked with ABA, in the sense of being real -ized through it, then
the cultural and economic legitimacy of ABA rhetoric, practices, and business is made all the
more powerful. If a parent chooses to espouse hope for their son or daughter (and what parent
would not choose hope over despair?), and this is the only “real,” legitimate, or true hope
offered, of course parents might be inclined to embrace not only the vision being offered but also
the espoused methodology that claims the ability to deliver that vision. And that conceptual
apparatus undergirds the lucrative and proliferating autism industries, thus demonstrating that a
truth claim is always not only about the politics of hope, but also about the politics of truth, and
the “economic and political role” such claims play (Foucault, 1980, p. 132).

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CHAPTER FIVE

The Politics of Truth:

Deploying Scientism in ABA Rhetoric

I F “RECOVERY [TO NORMALCY]” is branded in ABA rhetoric as the desired end, the vision of hope,
for young autistic children, then “science” is similarly branded as the means to that end, the
avenue by which that hope may be realized. From 1987–2000, the rhetoric of “science”—as that
of “recovery”—was taken up frequently, widely, and in many different spheres within the ABA
discourse community—from parent autobiographical narratives, to popular and electronic media,
to the listserv and early social media conversations of parents of young autistic children—and
ultimately was institutionalized within government documents. Similar to the branding of
“recovery” from autism, ABA’s branding of itself as “scientific” draws upon a powerful and
highly culturally valued—what Harvey (2007) might call a “compelling and seductive” (p. 5)—
idea. And if “recovery” from autism appeals powerfully and intuitively to our collective
(however ableist) cultural desires, “science” appeals just as powerfully to our collective cultural
values, as a truth claim engendering both legitimacy and trust. Both are necessary to advance a
conceptual apparatus that has the potential to become taken for granted, common sense,
hegemonic—true. The genius of the ABA rebranding campaign was not merely its deployment
and exploitation of these two powerfully charged cultural desires and values (“recovery” and
“science”), but more importantly, the ways in which that deployment inextricably intertwined
both of these values not only with one another and with our sense of possibilities and hope in the
social world, but also, and crucially, with a primary product on offer in the autism industry
(ABA intervention).
In analyzing the rhetoric of “science” within the ABA rebranding exercise, I illuminate the
complex Foucauldian dynamics of power/knowledge production—in effect, the rebrand’s skillful
navigation of the politics of truth. Indeed, I share Foucault’s concern with explicating “regime[s]
of truth” and what he calls the “‘political economy’ of truth” (Foucault, 1980, p. 131). According
to Foucault:

There is a battle “for truth,” or at least “around truth”—it being understood once again that by truth I . . . mean . . . “the
ensemble of rules according to which the true and the false are separated and specific effects of power attached to the
true,” it being understood also that it’s not a matter of a battle “on behalf” of the truth, but of a battle about the status of
truth and the economic and political role it plays. . . . “Truth” is linked in a circular relation with systems of power which
produce and sustain it, and to effects of power which it induces and which extend it. A “regime” of truth. (pp. 132–133)

Thus, in exploring the “systems of power” which “produce and sustain” truth, the Foucauldian
task becomes one of analyzing the cultural performativity of rhetorical and discursive practice—
what are the specific economic and political effects of power attached to “the true”? What is at
stake, and what is the ensemble of rules deployed in the battle over the status of truth, and in the
branding of particular truth claims?
As recounted in Chapter Four, in one of my earliest conversations with parents about their
children’s early education, I asked the mother of a 4-year-old autistic child how she had decided
to pursue intensive ABA intervention with her son, and she responded, “It’s the only thing that’s
been scientifically proven to work in recovering kids with autism—why would we do anything
else?” Why, indeed? Carmen uttered this somewhat incredulous (that anyone would be ignorant
enough to ask such a question) and rather exasperated response to me more than 20 years ago,
and I remain haunted by the incisiveness with which she pinpointed the crux of the matter. The
rhetorical tag, “why would we do anything else?” implies that there exists some sort of shared
commonsense understanding that the decision would present as self-evident—that “of course”
she and her husband had decided to use ABA with their son. The notion of “recovering kids from
autism” clearly appealed strongly to this mother’s desires for her son and to her hopes for future
possibilities inherent in the social world for her son. Equally clearly, the notion of “scientific
proof” appealed so strongly to this mother’s values, intuitions, and instincts that the strength
accorded its claim to legitimacy (as “scientifically proven”) enabled the claim itself to be
accepted without question as truth—so embedded in common sense as to be taken for granted,
not open to question: the effects of power attached to the true.
There is a reason that the development of necessary rhetorical and ideological architecture
precedes the institutionalization of the economic and policy architecture in the AIC.
Institutionalized economic hegemony nearly always follows and is built upon and through
rhetorical and ideological and ontological hegemony, which themselves (in this case) are
inscribed upon and within autistic bodies. Dolmage (2018) defines rhetoric as “the strategic
study of the circulation of power through communication ” (p. 2, emphasis in original).
Crucially, rhetorical analyses must be strategic—that is, they must offer, as Dolmage suggests,
critical analyses of “the larger patterns and plans that orchestrate possibilities” (p. 2). As I
previously argued, rhetoric is, and always has been, integral to what autism means, what it is,
and therefore (crucially), what it does. Dolmage argues that “if we can agree that rhetoric shapes
bodies, even partially, then we should study this shaping very carefully” (p. 13). What
possibilities are orchestrated through these rhetorical patterns in the deployment of power in this
rebranding initiative? What material, bodily realities do particular rhetorical understandings of
autism create? What material, bodily possibilities might they obscure? As Dolmage argued about
the creation of disability as an ontological category, so, too, I argue about the creation of the
AIC: its very existence has been “shaped by material spaces and corporeal experiences, and also
by languages and grammars” (p. 13) that ultimately consolidate economic and political power.
In this analysis, I consider the ways in which these languages and grammars of “science,” as
deployments of power circulating within and produced by particular regimes of truth, enter
institutionalized spaces. The skillful rhetorical engagement in the battle around truth is an
additional facet of the wild success of this rebranding campaign, linked in circular relation with
both the systems of power that “produce and sustain it,” as well as the effects of power that it
“induces” and that “extend it” (Foucault, 1980, p. 133), thus extending the reach and the
entrenchment (and ultimately, the profitability) of the AIC.

Branding and “Science”: Deploying Scientism

Science is a useful and necessary, though imperfect, human endeavor, and science is also
inherently ideological. By that I do not mean that the earth is flat if I believe or insist it to be so,
nor that statistical documentation of the exponential nature of pandemic viral spread is a hoax
perpetrated by socialist ideologues seeking to unseat a U.S. president, nor that the MMR vaccine
is a pharmaceutical industry conspiracy to cause autism. Stating that science is inherently
ideological does not make me anti-scientific (though I expect some will undoubtedly levy that
scientistic indictment). Science is a human endeavor by which we seek to better understand the
physical (and—vastly more challenging—social) world through systematic methods of inquiry,
including observation, exploration, experimentation, and ultimately (always) interpretation. And
because humans do not and cannot exist outside of ideology, the scientific endeavor—a process
engaged in and mediated through human activity—is necessarily performed with/in—not without
—ideology.
Science is also a discourse. Science is not merely a method; it is a language, a grammar, a
vocabulary, and a politically and culturally performative claim to authority, legitimacy, and
ultimately, truth. The discourse of science is central to the “ensemble of rules according to which
the true and the false are separated and specific effects of power are attached to the true”
(Foucault, 1980, p. 132). Generally speaking, the discourse of science is deployed to render a
claim legible, accurate, true, trustworthy, legitimate. Science lends weight. Science yields truth,
and significantly, therefore, power (i.e., effects attached to the true). Social policy must be
informed by comprehensive scientific understandings of complex social problems. However, as
Haack (2012) observes, “Science is a good thing,” but “science is by no means a perfectly good
thing” (p. 75, emphasis in original).
Sometimes claims purported to be “scientific” may more accurately be described as
“scientistic,” the claims themselves, manifestations of scientism. Haack (2012) in her “Six Signs
of Scientism,” describes scientism as “a kind of over-enthusiastic and uncritically deferential
attitude towards science, an inability to see or an unwillingness to acknowledge its fallibility, its
limitations, and its potential dangers” (p. 76). I will go one further and argue that sometimes
scientism stems not merely from an “inability” or “unwillingness” to acknowledge the
limitations and potential dangers of scientific processes, but rather from a strategic decision to
actively deploy the discourse of science to establish, gain, or consolidate economic or political
power, particularly when in the context of seeking to shape public opinion and/or to garner
support for one’s position on a political, ideological, policy, or commercial issue or venture.
How are we to reasonably distinguish between claims to “science” and its more craven
rhetorical deployment, “scientism”? Haack (2012) argues that there are six telltale “signs” that
what is purporting to be science may be better described as scientism. These include:
1. Using the words science, scientific, scientifically, scientist, etc., honorifically, as generic terms of epistemic praise.

2. Adopting the manners, the trappings, the technical terminology, etc., of the sciences, irrespective of their real
usefulness.

3. A preoccupation with demarcation, i.e., with drawing a sharp line between genuine science, the real thing, and
“pseudoscientific” imposters.

4. A corresponding preoccupation with identifying the “scientific method,” presumed to explain how the sciences have
been so successful.

5. Looking to the sciences for answers to questions beyond their scope.

6. Denying or denigrating the legitimacy or the worth of other kinds of inquiry besides the scientific, or the value of
human activities other than inquiry, such as poetry or art. (pp. 77–78)

The rebranding of ABA as “scientific” during the late 1980s and ‘90s presents examples of all
six of these telltale signs of scientism; however, recognizing these signs of scientism is not the
point, and their existence is not in and of itself the problem. The problem, rather, is what happens
when,“[i]n a society that grants so much cultural authority to scientists,” truth claimants or their
interlocutors “marshal their own scientific credentials to back their claims,” and when those
credentials “bestow rhetorical power” (Martin, n.d., n.p.), particularly when that power is not
necessarily derived from, nor warranted by, the substance of the claim itself. The point is to
study this circulation, exercise, and deployment of power through scientific (and scientistic)
rhetoric in the battle around truth, and in the political economy of truth: the effects of power
attached to the true. Haack (2012) reminds us, “much scientific work is unimaginative or banal,
some is weak or careless, and some is outright corrupt . . . for knowledge is power . . . and power
can be abused” (pp. 75–76 emphasis in original).
As will become clear in the analysis that follows, each of these features of scientism is
evident in ABA’s largely successful rebranding from 1987–1999. The rhetoric of “science” (that
is, scientism) deployed in the rebranding asserts a clear and unambiguous demarcation between
that which is asserted to be “scientific” and that which is derisively cast as its opposite
(alternately as “pseudoscientific” or even “anti-scientific”). Additionally, while claiming a
singular “science” as its own, applying that moniker to a very narrow swathe of scientific
inquiry, and coupled with a preoccupation with identifying and explaining “the scientific
method,” many additional modes of inquiry are obscured and indeed silenced. More troubling,
we can see clearly the ways that scientism is purposefully (and skillfully) deployed precisely
because of the cultural authority afforded to scientists and the rhetorical power that authority
lends to one’s position. Finally, we see the ways in which complex political, ethical, and
ideological issues are tactically reduced to “straightforward scientific hypotheses” that
“misconstrue” the complexity of the issues and that “overlook” the positions of important
constituencies affected by these debates. Of course, these difficulties with (even tendencies
toward?) scientism have been evident from the advent of modern scientific discourse. As Haack
(2012) observes, Francis Bacon (1561–1626) wrote about science “like a promoter” or “like a
marketer,” himself far more keenly aware of science’s “virtues than of its limitations and
potential dangers” (p. 75). And while scientific inquiry offers humankind a highly valued and
indispensable set of tools for better understanding complex natural and human conditions,
scientism is ultimately the more effective (and more dangerous) marketing tool.

Science, Hope, and ABA

The rhetoric of “science” figures prominently in Maurice’s (1993) autobiographical text, and her
understanding of the construct appears to be integral to realizing the vision of hope she holds for
her son and daughter—that of “recovery” from autism. Holding a PhD herself in French
literature and criticism, she describes herself as having “crave[d] . . . Objectivity. Empirical
research” (p. 16) in her search for information about autism. She positions “science” as
something entirely different from and other than her own training in the humanities and social
sciences:

After gamely agreeing to look at beloved works of poetry and fiction through the diverse lenses of structuralism,
poststructuralism, phenomenology, feminist criticism, deconstruction, I pounced on medicine like some poor fact-starved
rat. I was tired of truth as a relative term, a shift of one’s perspective, a way of seeing. Information was what I wanted to
try on for size. Science. A corpus of knowledge validated by whether its data held together empirically, not by whether its
practitioners had the gift of gab. (p. 16)
In forming a particular construct of science, Maurice uses lexical and discursive markers that
clearly elicit a particular image of science in the reader’s head—the constructs of “facts,” “data,”
“validation,” and “empiricism” are central to her description, as is the notion of a “corpus of
knowledge.” In addition to the image of a body of scientific knowledge in this example,
elsewhere Maurice draws upon Enlightenment imagery by describing “science” as “voices of
reason in the wilderness” (p. 117) and by referring to “the light of scientific objectivity” (p. 285).
Maurice also explicitly impresses upon her readers a very specific image of science when she
posits “the idea that psychology could actually aspire to the rigorous methodology of a science—
verifiable data, accountability, controlled research, openness to peer scrutiny . . . ” (p. 168).
Indeed, the discourse around “science” deployed in Maurice’s account is further bolstered by
the bookended foreword and afterword, respectively authored by Bernard Rimland, director of
Autism Research International, and Lovaas himself, both of whom worked with parents of
autistic children in 1965 to form the NSAC (currently ASA). In the foreword, Rimland describes
behavior modification as “a scientifically validated, time-tested curriculum for the effective
teaching of autistic and other learning-impaired children” (p. xv). In the afterword, Lovaas writes
that “this book also demonstrates the importance of selecting treatments that are supported with
scientific data” (p. 324), and expresses his hope and confidence that “science will generate
effective treatments for autism” (p. 325).
In the decade following publication of Maurice’s (1993) text, an abundant and active popular
rhetoric around ABA circulated in newspaper, listserv, and television texts, driven largely by
parents sharing stories of their own children and of their own struggles to access and fund home
ABA programs. Much of the popular rhetoric around ABA as early intervention for young
autistic children pointed to Maurice’s (1993) story and Lovaas’s (1987) study as touchstones
(even referring to ABA generally as “the Lovaas method”), and systematically invoked the
concept of “science” in defining and advocating for ABA. Indeed, at that time, a feature article
on autism and ABA in the New York Times stated that “comprehensive applied behavioral
analysis, based on the principles set forth by B. F. Skinner in the 1930s, is the only program
backed by scientific data” (Feller, 1999). Other feature articles in the popular press similarly
constructed ABA as “scientific,” referring to “the science-based applied behavior analysis”
(“Autism center deserves community’s support,” 1999), “its [ABA’s] science-based approach to
autism,” (Cook, 1996), and “a treatment option that’s based on science, . . . that’s what applied
behavioral analysis is all about” (Cook, 1996). The description of ABA as “scientific” or
“science-based” was thus a central feature of 1990s ABA rhetoric, across multiple data sources,
many of which directly index Maurice’s (1993) autobiographical text.
Following the publication of her own family’s story, Maurice went on to coedit a manual on
the use of behavioral intervention for young autistic children (Maurice et al., 1996; hereafter
referred to as “the Manual”), and the rhetoric around “science” in the Manual figured even more
prominently than it had in her autobiographical text. In the introduction to that Manual, Maurice
reasserted that “scientific research shows that Applied Behavior Analysis has consistently
achieved the most significant results for children with autism” (p. 9), and coeditor PhD
behaviorist Gina Green reiterated that “Objective, scientific evidence about treatment
effectiveness makes up much of the research literature in Applied Behavior Analysis” (p. 20).
Two years later, in 1998, Green, Maurice, and others cofounded the nonprofit Association for
Science in Autism Treatment (ASAT). The organization’s logo on its website currently features
the tagline, “Real Science, Real Hope” (https://asatonline.org/), and a majority of its board of
directors and professional advisory board members are BCBAs. The branding of this nonprofit
thus encapsulates the conceptual and rhetorical triumvirate that Maurice (1993) was the first to
braid together: science, hope, and ABA.
It is worth articulating that the notion of intervention (behavioral or otherwise) not being an
integral conceptual component of autism is rendered completely invisible (or more accurately, is
completely nonexistent) within this discourse. A foundational working assumption of the
conceptual apparatus successfully advanced to this point is that (of course) autism requires
intervention, and scientism is deployed in a rhetorical power play to assert the authority of one
particular intervention methodology (ABA) as the only suitable or warranted intervention. The
question of whether (any) intervention is always necessary or beneficial (or desired) is never
even considered. By the turn of the century, the rhetorical and ideological apparatus of the AIC
had already accomplished that much.

“Science” versus “Ideology”

A prominent feature of the scientistic rhetoric of ABA intervention for young autistic children in
the 1990s was the way in which the claimed “scientific” nature of the method was discursively
constructed in opposition to other methods that were constructed as nonscientific and
“ideological,” thereby rhetorically implying that the position of advocating for the widespread
use of ABA for young autistic children was somehow neutral or objective and nonideological.
Maurice (1996) stated in her introduction to the Manual:

[I]t had become apparent to me . . . that the autism world continued to be dominated by an astonishing amount of
misinformation, false expertise, and ferocious ideological warfare. It was equally apparent, given the growing research
findings about the value of early intervention, that there was a critical need for parents to gain access to science-based,
accurate information about such intervention. (p. 6)

Maurice drew upon simple, binary Platonic dualisms when she juxtaposed the “appeal to the
emotions” of all of the other interventions for autism with the “appeal to reason” (p. 6) offered
by ABA. In describing the myriad of “nonscientific” interventions for autism, Maurice drew
upon language such as “unsupported claims,” “curative powers,” “powers . . . to heal,” “New
Age gurus,” “charlatanism,” “quackery,” “nonsense,” “scandal,” “messiahs,” “moon dust elixir,”
and “magic bullets” (pp. 5–6). (See Table 5.1 for a summary of these data.) Why indeed would
one do anything else if these represented the alternatives to ABA?
Table 5.1: Rhetorical Analysis of the Language Used to Describe “Scientific” ABA Intervention vs. Other (Described as
“Nonscientific”) Interventions for Autism

Language describing “scientific” ABA intervention: Language describing other (“nonscientific”) interventions for
autism:
appeal to reason appeal to emotions
factual information opinion
science-based truth as a relative term
time-tested gift of gab
objective data received wisdom
highest possible degree of reliability pseudoscience
well-founded antiscience
objectively validated misinformation
corpus of knowledge false expertise
validated ferocious ideological warfare
data unsupported claims
held together empirically curative powers
voices of reason in the wilderness powers . . . to heal
the light of scientific objectivity New Age gurus
 professional scrutiny charlatanism
peer review quackery
objective validation nonsense
the test of time scandal
direct, objective observation and measurement of messiahs
phenomena moon dust elixir
systematic magic bullets
procedures to rule out alternative explanations personal beliefs
repeated demonstrations (called replications) social movements
accurate information advozealots
evidence faith
disciplined science unproven therapies
rigorous methodology ideologue
Data drawn from the following texts: “Autism center deserves community’s support” (1999), Cook (1996), Fanlight Productions
(1998), Feller (1999), Greene (1996), Kirkus Reviews (1993), Lovaas (1993), Maurice (1993), Maurice et al. (1996), New York
State Department of Health (1999a, 1999b, 1999c), Rimland (1993), Sege (1993), van den Nieuwenhof (1996), Weizel (1995),
Wolfe (1993). Reprinted from Broderick (2011).

ABA discourse rhetorically constructed its own claims to legitimacy and authority partially
through contrast with a comparative discourse of illegitimacy. Thus, the claims to neutrality
afforded by the constructing of “science” in opposition to “ideology” were integrally related to
the legitimacy of the discourse as well. A New York Times feature article on autism and ABA
stated:
Desperate parents are willing to try anything. Some have their children swim with dolphins or subject them to injections
of sheep placenta. Others put their faith in techniques known as forced holding or facilitated communication and other
unproven therapies. . . . Comprehensive applied behavior analysis . . . is the only program backed by scientific data.
(Feller, 1999, p. 15)

Thus, the “scientific” legitimacy of ABA was discursively constructed in opposition to images of
“desperate” parents placing their “faith” in “unproven therapies,” “willing to try” or “subject”
their children to “anything.” Just as Maurice had constructed ABA as “reason” as opposed to
“emotion,” this particular article constructed ABA as “science” as opposed to “faith.” Similarly,
a 1996 CBC video segment on autism and ABA described ABA as “a treatment option that’s
based on science . . . it’s not swimming with the dolphins” (Cook, 1996).
In a chapter in the Manual titled, “Evaluating Claims About Treatments for Autism,” Green
(1996) stated:
[D]ebates about causes and treatments tend to provoke intense emotional responses. The search for information and help
is thus influenced at least as much by ideologies, personal beliefs, and social movements as by logic and objective data. . .
. The situation in autism treatment is largely the opposite of disciplined science. (pp. 15–16)

Debates about treatments were thus described as “emotional,” “influenced . . . by ideologies,

personal beliefs, and social movements,” and as “largely the opposite of disciplined science.”
However, by aligning the rhetoric of ABA treatment squarely within the realm of “disciplined
science,” the impression was created that ABA had no grounding in emotion, ideology, personal
belief, social or political movement, or financial interest. Maurice (1993) recounted the response
of a director of a therapeutic nursery upon visiting a school that employed ABA—“I would
invite you to come see our program, but I know you [Maurice] would hate it as much as I hate
yours”—calling her an “ideologue” (p. 283). While acknowledging the radical differences of
perspective between the two programs, Maurice seemed to imply that the therapeutic nursery
director’s distaste for the ABA program was entirely grounded in her ideological position, while
her own distaste for the therapeutic nursery program, somehow, was not at all grounded in her
own.
Maurice seemed to confuse the concepts “being an ideologue” with “having ideology”
(Brantlinger, 1997), and indeed seemed to imply that having positioned itself as “scientific,” the
position of ABA advocacy was therefore nonideological somehow. Rimland (1993), in the
foreword to Maurice’s autobiographical text, similarly confused (or conflated) these concepts:

The empirical data, however, show clearly that strongly structured behavioral programs have consistently yielded highly
beneficial results for most autistic children. And yet, despite the evidence, some people remain so adamantly opposed to
the enforcement of discipline that I refer to them as advozealots—people who purport to be advocates for children but
instead are really advocates for their particular ideology. (p. xvi)

In the discursive construction of “the evidence” and “the empirical data” in opposition to
“advozealots—people who . . . are . . . advocates for their particular ideology,” one might note a
curious absence of any human subject in the construction of the former position. The “evidence”
and the “data” are constructed as neutral, as though they somehow speak for themselves without
any human interlocutor to taint them with his or her subjectivity, politics, or ideology. Indeed, it
seems as though Rimland was suggesting that the “scientific” view was tantamount to “the view
from nowhere,” a position that Haraway (1988) reminds us does not exist.

“Science” Selectively Applied to Positivist Science

Another dominant feature of the scientistic rhetoric of ABA intervention discourse during this
time was its highly selective and very narrow rhetorical referent for the moniker of “science”
within its own discourse. ABA rhetoric during this time relied heavily upon repeated honorific
descriptions of the method as “scientific,” and the broad construct of science was selectively
applied in this discourse to the narrow field of positivist inquiry, thus obscuring the existence of
other fields and forms of scientific inquiry (to say nothing of nonscientific forms of inquiry).
In the introduction to the Manual, Maurice spoke both for herself and on behalf of the many
parents who contacted her following the publication of her autobiographical text:
We need factual information, preferably science-based and time-tested. We don’t need everyone’s opinion; we need
objective data with the highest possible degree of reliability. We need guidance that is truly well-founded and objectively
validated. (Maurice et al., 1996, p. 3)

Thus, on the very first page of the introduction to this text, Maurice invoked the constructs of
objectivity, reliability, and validity, the cornerstones of positivist science and quantitative
methodology. Interestingly, this “science-based,” “factual information” was described in
contradistinction to “opinion,” thus implying that any information not presenting as “objective
data with the highest degree of reliability” that was “objectively validated” was therefore not
“science-based,” and was likely mere “opinion.”
Throughout the Manual, a clear and consistent image of what “science” is and is not was
developed by the contributing authors. In describing the criteria for inclusion as a contributor to
the edited Manual, Maurice stated:
We needed people who believed in the value of objective data and results, as opposed to “received wisdom” of any sort.
We needed people who understood the importance of a science-based approach to autism treatment, an approach that
welcomed professional scrutiny, peer review, objective validation, and the test of time. (Maurice et al., 1996, p. 7)

Additionally, in a chapter in the Manual advising parents how to evaluate claims about
treatments for autism, Green (1996) provided a succinct definition of exactly what she believes
science to be (which she presented in opposition to the constructs of “pseudoscience” and
“antiscience”). According to Green, science:
relies on direct, objective observation and measurement of phenomena, systematic arrangements of events, procedures to
rule out alternative explanations for what is observed, and repeated demonstrations (called replications) by individuals
working independently of one another. (pp. 15–16)

It becomes clear from this definition that when Green uses the term science, she referred only to
that subset of science that is grounded in a positivist epistemology and that utilizes quantitative
methodology, specifically, experimental design. Any form of inquiry or knowledge not fitting
into this narrow definition of science, in Green’s conceptualization of the empirical world, was
relegated to the status of that which is not science (be it “pseudoscience” or “anti-science”). Her
definition of science became even more circumscribed when she effectively limited the status of
“sound scientific evidence” to be conferred only upon one particular type of experimental design
—the treatment-effect study. According to Green (1996), treatment effects “must be verified
through systematic, experimental research using objective measurement procedures and controls
to rule out alternative explanations for apparent effects” (p. 17).
Interestingly, although Green (1996) acknowledged the existence of other forms of research,
stating that “research comes in many varieties” (p. 21) (e.g., qualitative research, which is
described as being “purely descriptive”), she (not surprisingly) did not acknowledge these
alternative forms of inquiry as “scientific.” In granting the essential role that qualitative research
can play in “painting comprehensive and detailed pictures of phenomena and the contexts in
which they occur, often organizing the details in ways that can serve a host of purposes” (p. 21),
Green referred to the qualitative researcher as “the observer.” However, when describing the role
of the experimental researcher she referred to “the scientist” (p. 22). Clearly, the legitimacy and
authority culturally conferred upon the researcher called scientist will be greater than that
accorded the researcher called observer, and the contributions of the two will be weighed
respectively, as Green herself recommended. As Green pointed out, the “soundness” of this
scientific evidence should in part be weighed by the “qualifications of those who study, promote,
and implement the treatment” (p. 17), and her narrow construction of the terms science and
scientist thus effectively dismissed entire bodies of knowledge (and the researchers studying
them) as illegitimate, not worthy of serious consideration.

Scientism as Branding Tactic

The ABA intervention industry’s systematic deployment of the rhetoric and discourse of
“science” during this period of time transparently displays most of Haack’s (2012) telltale
“signs” of scientism. The first sign—the use of words like science, scientific, scientifically,
scientist, etc., honorifically, as generic terms of epistemic praise—is actually powerfully
amplified by the neoliberalist tendency to “go big or go home” in branding and public relations
campaigns: we see not merely the sporadic or occasional use of the rhetoric of “science” to
generally convey epistemic praise; we see, rather, the repeated, consistent, and widespread
barrage of this scientistic rhetorical move as a coordinated and orchestrated “messaging”
strategy. If asserted often enough, and brazenly enough, it somehow becomes True.
Similarly, we see evident in this analysis copious examples of Haack’s (2012) third sign of
scientism, “a preoccupation with demarcation, i.e., with drawing a sharp line between genuine
science, the real thing, and ‘pseudo-scientific’ imposters” coupled and performed in tandem with
multiple examples of Haack’s sixth sign of scientism, “denying or denigrating the legitimacy or
the worth of other kinds of inquiry besides the scientific” (pp. 77–78). The contrasting
vocabularies deployed by Maurice and others in a single set of rhetorical moves neatly and
largely successfully (as judged by the extent to which this vocabulary was taken up and
rearticulated by others in public discourse) drew a demarcating line between “scientific” ABA
and allegedly “pseudoscientific” imposters, whilst simultaneously denigrating the legitimacy
those “imposters” by the systematic use of terms such as quackery, charlatans, nonsense, moon
dust elixir, etc.
Hope. Recovery. Normalcy. Science. Truth. It is precisely because our cultural narratives,
models, images, and myths are so familiar that they manage to mediate one’s “understanding of
the world” in these “profoundly unconscious ways.” This is when rhetoric becomes what
Dolmage (2018) calls “scarily effective” (p. 3). Ideology is at its most powerful when at its least
visible and its most profoundly unconscious. This is ideology as a “hegemonic . . . mode of
discourse” that therefore “has pervasive effects on ways of thought to the point where it has
become incorporated into the common-sense way many of us interpret, live in, and understand
the world” (Harvey, 2007, p. 3). It is claims to ideological neutrality and scientific legitimacy
such as those of Maurice, Green, Rimland, and others that beg the most thorough ideological
analysis, precisely because the ideological complex of narratives they espouse function
collectively to insulate their position (and that position’s believers) not only from criticism, but
sometimes even from perception. Let me be clear: ideological neutrality and scientific legitimacy
(i.e., cultural claims to trustworthiness and authority in general) are necessary, foundational, and
requisite forms of currency—reputational currency—needed to seed a burgeoning commercial
venture. And cornering the market on reputational currency will likely yield a significantly
outsized market share for your offered products and services in the years to come.

Regimes of Truth: Scientism in Policy Documents

Beyond simply identifying the rather clear signs of scientism in ABA discourse during this time,
we must also critically analyze the ethical and moral implications inherent in these scientistic
deployments. Martin (n.d.) expressed the concern that “proponents of scientism sometimes
marshal their own scientific credentials to back their claims,” and “[i]n a society that grants so
much cultural authority to scientists, those credentials can easily bestow rhetorical power” (n.p.).
It is this political (i.e., for the purposes of exercising power) deployment of “scientific” discourse
that is so problematic, particularly when one considers that the ideological architecture being
branded here is but one layer of the AIC, and that layer is itself the foundation for the economic
architecture that is to follow (see Part Three). That is, these foundational ideological products of
the AIC—autism as a social problem and the cultural logic of intervention, packaged and sold for
consumption through this highly effective rebranding initiative—will ultimately serve as the
scaffolding for the subsequent profit-generating architecture: the autism intervention and
prevention industries.
The year 1999 marked a turning point in the ABA rebranding initiative and in the building of
the central architecture of the AIC. The preceding analysis examined the ways that a disciplined
and systematically deployed rhetorical strategy served to culturally confer legitimacy and
trustworthiness upon the language and practices (and practitioners) of ABA as a necessary
intervention for young autistic children. While the years from 1987 to 1999 had primarily
worked to produce the rhetorical and ideological architecture of the AIC, by 1999, we begin to
see the first evidence of its material institutionalization within government policy, thereby
lending these rhetorical claims even further legitimacy, authority, and, ultimately, power: in
1999, the New York State Department of Health published a set of early intervention policy
guidelines for young autistic children. The publication of this set of documents in 1999 marks the
point at which this rhetoric shifts from being ubiquitous, pervasive, and dominant, to being
hegemonic, granting not only legitimacy but also cultural authority through the rhetoric’s
institutionalization within policy architecture. From 1999 onward, the “truth” propagated by
ABA rhetoric became “linked in a circular relation with systems of power which produce and
sustain it, and to effects of power which it induces and which extend it. A ‘regime’ of truth”
(Foucault, 1980, pp. 132–133).
In 1999, the New York State Department of Health (1999a, 1999b, 1999c) issued three
different versions of a document called the Clinical Practice Guideline for Assessment and
Intervention of Young Children with Autism/Pervasive Developmental Disorder (hereafter the
Guideline). In reviewing these documents it would seem evident even to a naive reader that the
rhetoric of “science” is pervasive throughout. For example, the stated purpose of the Guideline is
to “review the scientific evidence . . . available,” and, combined with “expert clinical judgment,”
to “develop evidence-based guideline recommendations on assessment and intervention of young
children with autism” (1999a, p. I-3). This is to be achieved by “using a scientific process that is
evidence-based,” thereby “developing a guideline that is valid, objective, and credible” (1999a,
p. I-3). What may not be immediately evident to many readers is the recognition that the rhetoric
identified as “science” in these documents borders on the scientistic. And although the Guideline
documents are explicitly identified as containing recommendations for “best practice,” not
policies, regulations, or required standards of practice, the documents nevertheless clearly locate
the panel’s recommendations within the powerful cultural authority and legitimacy afforded to
positivist constructs of empirical science, with its tenets of validity, reliability, efficacy, and
objectivity (to say nothing of the authority accorded the position of a government agency).
In the Guideline documents, information is represented not as information or as data but as
“evidence.” The opinions of the panel members are similarly represented not as opinions that are
positioned within and informed by one’s values and professional positionality, but rather as
“expert clinical judgment.” Thus, by constructing “scientific evidence” and “expert judgment” as
the only recognized forms of legitimate knowledge, the discourse itself de facto constructs as
illegitimate all forms of knowledge that do not fall within those particular narrowly constructed
definitions. Throughout the text of the Guideline, the positivist construction of “science” is
thereby asserted and legitimized, while at the same time the possibility of other forms of
knowledge are so effectively obscured as to be rendered nearly invisible.
Ideology is at its most powerful when its workings are least visible. Thus, among the most
significant political decisions made by members of the panel were those decisions that neatly
obscured the ideological position of the panel itself. Arguably the most significant of these
decisions—largely due to its invisibility to the public—was the determination of what constituted
“adequate scientific evidence” about efficacy for consideration in the panel’s review of evidence.
In a list of general criteria for selection of studies for review, it is specified that studies using
group designs had to “be controlled trials evaluating a group receiving the intervention compared
to a group(s) receiving no intervention or a different intervention” (1999a, p. I-17). In other
words, only quantitative, experimental design, treatment-effect studies would meet the criteria of
adequate scientific evidence of efficacy. Significantly, this description of “controlled trials”
omitted the criterion that those trials be randomized, in which participants are randomly assigned
to either treatment or control groups and which is generally regarded as the gold standard of
highly rigorous experimental scientific inquiry.
It is curious that this description of “adequate scientific evidence,” rather than reflect the
most rigorous widely accepted positivist criteria for evaluating the validity of experimental
research results generally, instead specifically and precisely described the exact methodological
design of Lovaas’s study (including its most significant methodological flaw, the absence of
randomized group assignment). Thus, through rhetorical and discursive practices defining
“adequate scientific evidence” narrowly enough to exclude forms of knowledge and inquiry that
were not experimental, treatment-effect studies (thus relegating other scholarship and inquiry to
the status of nonscientific, illegitimate forms of knowledge that were not considered by the
panel), but broadly enough not to exclude Lovaas’s study on the basis of its nonrandomized
group assignment (generally regarded as a serious methodological flaw), the Guidelines criteria
neatly narrowed the field to just a few studies to consider, and coincidentally (surprise!)
positioned Lovaas (1987) as the most scientifically rigorous study available for review.
In the Guideline Technical Report (NYSDH, 1999a), the most complete and lengthy version
of the document, this information on how the committee discursively and rhetorically constituted
the working construct of “scientific evidence” and what is and is not regarded as “evidence” was
included as a table in the main body of the text (and probably nobody read that but me). In the
somewhat abridged version, the Report of the Recommendations (NYSDH, 1999c), this
information is relegated to an appendix (and who reads appendices, anyway?). In the Quick
Reference Guide (NYSDH, 1999b), which is the most condensed version that was most widely
distributed to parents and schools and the general public, this information was not included at all,
thus rendering these decisions completely invisible to parents and practitioners through omission
from the most widely disseminated version of the document. With the assumptions underlying
the panel’s definition of “scientific evidence” thus obscured, all that remains to parents and
school personnel reading the Quick Reference Guide (NYSDH, 1999b) is the pervasive and
honorific language of positivist scientific discourse (e.g., “effectiveness,” “studied extensively
and rigorously,” “evidence-based,” “scientific evidence,” etc. [p. 4]), and the reassurance of the
panel that this document represents their “attempt to interpret the available scientific evidence in
a systematic and unbiased fashion” (p. 4).
The primary finding of the panel was that “intensive behavioral intervention programs have
an extensive grounding in scientifically validated principles of behavior and learning” (1999a, p.
IV-24), and their primary recommendation for practice was: “Since intensive behavioral
programs appear to be effective in young children with autism, it is recommended that principles
of applied behavior analysis and behavioral intervention strategies be included as an important
element of any intervention program” (1999a, p. IV-25). With the exception of experimental
research on pharmacological interventions, the panel reports that it found no “adequate”
scientific evidence that would support the use of any intervention other than intensive applied
behavior analysis for young autistic children. (And the question being considered was not
whether to intervene, but how.) The discursive decisions made by the panel members in
constructing the Guideline documents thus serve to strongly suggest that the use of ABA as an
early intervention for young children labeled with autism is the only legitimate avenue of
intervention available. This particular facet of the “scientific” discourse drawn upon in the
construction of these documents afford ABA advocates a position of considerable power and
cultural authority, while simultaneously obscuring the ideological bases of that power.
Although these state guidelines are not actual policy documents (i.e., they were not
prescriptive), they nevertheless were intended “to provide parents, professionals, and others with
recommendations based on the best scientific evidence available about ‘best practices’”
(NYSDH, 1999b, p. 1). Perhaps more significantly, however, they served as the first brick in the
interconnected and burgeoning regime of truth about ABA intervention that very quickly became
hegemonic. The power and legitimacy drawn upon in the production of these documents were
bolstered by the authority accorded the New York State Department of Health in making
treatment recommendations. And these documents, to this day, continue to underlie and serve as
a legitimating reference for both other states’ as well as the federal government’s policies on
autism. The primary conclusions of the New York State Guidelines—that ABA programs be
included in any early intervention, as they appeared to be effective and were evaluated by the
panel as evidencing no known harms to the recipients of the treatment (despite the fact that
Lovaas’s results had been obtained through the systematic deployment of contingent aversives,
including slaps, etc., to young children)—were in short order reiterated at the federal level by the
U.S. Surgeon General, whose 1999 report on mental health notes that “Intensive, sustained
special education programs and behavior therapy early in life can increase the ability of the child
with autism to acquire language and ability to learn” (U.S. Surgeon General, 1999, p. 163).
Following a brief discussion of the benefits of special education, the report states that “thirty
years of research demonstrated the efficacy of applied behavioral methods in reducing
inappropriate behavior and in increasing communication, learning, and appropriate social
behavior” (p. 164). The report then briefly describes the Lovaas study, characterized as a “well-
designed study of psychosocial intervention” (p. 164), and reports that “follow-up of the
experimental group in first grade, in late childhood, and in adolescence found that nearly half the
experimental group but almost none of the children in the matched control group were able to
participate in regular schooling” (p. 164). The U.S. Department of Education’s mention of ABA
intervention in its annual report to Congress on the IDEA (2000) was similar in content
(reiterating the Guidelines findings) and length (brief). In each of these cases, the repeatedly
described experience of just nine autistic children “able to participate in regular schooling” is
presented by trusted interlocutors (e.g., a state-level Department of Mental Health, the U.S.
Surgeon General, the U.S. Department of Education, etc.) as a glowing endorsement of not only
one particular (still never replicated) intervention design, but rather, an entire industry claiming
to be doing “what he did.”
Indeed, the field repeatedly (and somewhat perseveratively, one could argue) restates
endorsements of or claims about the efficacy and/or scientific legitimacy of ABA, relying
heavily upon the reputational currency of the interlocutor in enhancing the credibility of the
initial claim. For example, in the introduction to Dorsey et al.’s (2009) discussion of licensure
trends in ABA, the authors preface the discussion with

Over the past 10 years, the field of applied behavior analysis (ABA) has experienced extraordinary growth in the number
of practitioners as well as those seeking services. This change appears to be related to the explosion in the number of
children diagnosed with pervasive developmental disorder/autism and the recognition of the success of behavior analytic
treatments. Included among those who have spurred this growth forward are the United States Surgeon General (1999),
the U.S. Department of Education’s Office of Special Education (2000), the National Science Foundation (Lord &
McGee, 2001), and the New York Department of Health Clinical Practices (1999). (p. 53)

The authors are correct to credit this growth in some substantial part to the institutionalized
sources of authority and credibility that have reiterated Lovaas’s and Maurice’s rhetorical claims.
This “truth” is, as Foucault asserted, at least in part about “the economic and political role it
plays . . . linked in a circular relation with systems of power which produce and sustain it, and to
effects of power which it induces and which extend it,” therefore, “a ‘regime’ of truth”
(Foucault, 1980, pp. 132–133). And, consistent with Dolmage’s (2018) definition of rhetorical
analysis as the “strategic study of the circulation of power” (p. 2, emphasis in original) through
language, it is these systems of power, these “larger patterns and plans that orchestrate [and
constrain] possibilities” (p. 2, bracketed text added) that I illustrate in this analysis. And may I
presume to act as a rhetorician when I remind us, as Dolmage did, “that sometimes,
unfortunately, the ways that messages are shaped, delivered, repeated, and recirculated can be
just as important as their veracity, facticity, or truthfulness” (p. 2).
My analysis of the “scientific” legitimacy of the dominant (and now hegemonic) claims
about autism intervention and “treatment” is not unlike Gerald Coles’s (1989, 2000, 2003)
critiques of the “scientific” basis underlying the “diagnosis” of learning disability (LD), and its
reductionist “skills-based” educational interventions (to treat an allegedly neurological disorder),
deployed not only as intervention for students diagnosed with LDs, but increasingly, as best for
all children in literacy’s “phonics wars.” Like autism, LD was nonexistent as an ontological
entity a mere few decades before it exploded in diagnostic prevalence. Like autism, the early
research base on LD and its interventions was rather paltry, and yet repeated claims of “scientific
evidence” abounded, and professionals dedicated to studying and treating LD proliferated. Like
autism, LD interventions and their alleged “scientific evidence” quickly entered educational
policy documents as settled canon. And like autism, LD interventions were similarly linked to
large, private, for-profit commercial interests (in the case of LD and the reading wars, to
corporate curriculum publishers, primarily). We have seen this movie before.
In the final section of this chapter, I analyze the ways in which Haack’s fifth sign of
scientism—looking exclusively to science for answers to complex questions beyond the scope of
science—also pervades the behaviorist rebranding of ABA. Indeed, this particular structural flaw
in the conceptual architecture of the AIC has arguably kindled the emergence of a strong,
incisive, and increasingly well-organized autistic counternarrative to the AIC.

Naming Scientism and Moving Beyond Positivist Critique

In Chapter Four, I noted that there have been several positivist critiques of the notion of
“recovery” from autism in ABA discourse—that is, questioning whether “recovery from autism”
is “really possible?” (Cohen, 1998, p. 79), or in turn questioning whether the 9 children reported
upon in Lovaas’s (1987) study were actually “recovered” (Gresham & MacMillan, 1997).
Similarly, there have been a number of positivist critiques of the notion of “scientific proof” in
ABA discourse levied as well (Foxx, 1993; Gernsbacher, 2003; Herbert & Brandsma, 2001;
Herbert et al., 2002; Kazdin, 1993; Schopler et al., 1989). All of these early positivist critiques
missed the central problem of the rhetorical deployment of scientism, all effectively conceding
the underlying assumptions about science embedded therein, while arguing only the more
explicit surface claims. That may well be attributable to the fact that almost all of the early
positivist critiques were levied by fellow behaviorists (thereby, perhaps, making them more
conciliatory to the asserted ontological claims being made). A notable exception to these was
Gernsbacher (2003), which, although she is not a fellow behaviorist, nevertheless primarily
offered positivist critiques of ABA’s rhetorical claims to scientific legitimacy.

Positivist Critiques of ABA

Gernsbacher’s (2003) early critique—the title of which queries “Is One Style of Behavioral
Treatment for Autism ‘Scientifically Proven’?”—briefly summarizes the critiques levied by
other behaviorists against the repeated claims that ABA in general, and Lovaas’s study in
particular, constitute the only “scientifically proven” treatment for autism. Gernsbacher
references the New York State Guideline documents’ review of the literature and points out that
“only five articles met their own standards for adequate evidence” and that those articles report
on “only four studies” (2003, p. 3). However, of these four studies (Birnbrauer & Leach, 1993;
Lovaas, 1987; Sheinkopf & Siegel, 1998; Smith et al., 1997), only two (Brinbrauer & Leach,
1993; Lovaas, 1987) utilized experimental design, and neither of these experiments utilized
random assignment of participants to treatment versus control groups—a practice which,
according to Gernsbacher (2003) is, “as any scientist knows, . . . a core feature of scientific
credibility in treatment studies” (p. 3). Other authors have raised similar critiques, with Herbert
et al. (2002), for example, charging that no study to date has used “true experimental design, in
which subjects were randomly assigned to treatment conditions” (p. 37), and cautioning that such
methodological weaknesses “severely limit the conclusions that can be drawn about [the]
efficacy” (p. 37) of existing studies.
Gernsbacher (2003) additionally reviews a study published in 2000 by Smith et al., which she
calls the “first truly randomized trial of intensive early intervention for children with pervasive
developmental disorder” (p. 4). Smith et al. (2000) state that their study was designed to “address
criticisms of previous research and increase methodological rigor” (p. 271), and the findings of
this study report that only “two of the 15 intensively treated children met the criteria used by
Lovaas (1987) and McEachin et al. (1993) for classifying children as ‘best outcome’” (cited in
Gernsbacher, 2003, p. 5). Thus, according to Gernsbacher, “in contrast to Lovaas’s (1987)
reported 47% success rate . . . for children treated with Lovaas-style intervention, using the
scientifically crucial random assignment Smith et al. reported only a 13% success rate” (p. 5),
consisting of precisely two children. Gernsbacher thus urges readers to “exercise caution in
claiming that one style of intervention has been scientifically proven” (p. 6).
Writing more recently with autistic researcher Michelle Dawson in the Lancet, Gernsbacher
once again, together with Dawson this time, pushes back against overstated claims to ABA’s
scientific effectiveness as intervention for autistic children. Responding to a review of research
on the use of ABA intervention with autistic children published by Levy et al. (2009), Dawson
and Gernsbacher (2010) continue to contest, on the basis of insufficient empirical support, these
authors’ claims about and representations of the extant research literature on ABA intervention.
Dawson and Gernsbacher contend that the claims made by Levy et al., that

intensive programmes based on applied behaviour analysis (ABA) “were highly effective for up to half of children
enrolled in about ten randomised clinical trials done in the past 20 years” . . . have no basis—either in the review they cite
or in any other published study” (Dawson & Gernsbacher, 2010, n.p.).

Additionally, Dawson and Gernsbacher remind Lancet readers that the only published
randomized controlled trial to study intensive ABA-based programs for autistic children
continues to be Smith et al. (2000), and that, “as Rogers and Vismara note, the results of this one
very small study (intervention group n=15) do not support the claim that intensive ABA-based
programmes are ‘highly effective’, especially not for children with the specific diagnosis of
autism” (Dawson & Gernsbacher, 2010, n.p.), let alone the basic claim that there have been “ten
randomized clinical trials” of intensive ABA intervention with autistic children.
Responding to Dawson and Gernsbacher’s critique, Mandell et al. (2010) rejoin that “ a host
of other studies that used rigorous and sometimes not-so-rigorous quasi-experimental designs
point to the efficacy of ABA-based methods,” but admit that, “certainly, much more work is
needed” (p. 723). In addition, Levy et al. further explain to Lancet readers, “Our statement that
ABA-based methods have the most evidence to support them represents both an endorsement of
ABA but also an indictment of the rest of the treatment research field,” and they close by
reminding readers that the authors “eagerly await more rigorous trials of their efficacy” (p. 723),
with “their” referring to studies of the efficacy of nonbehavioral intervention models, such as
developmental and relationship-based therapies.
Yet another decade has passed, and still Smith et al. (2000) remains the only experimental
treatment-effect study of ABA intervention with young autistic children to have random
assignment to treatment and control groups (with a sample size of 15 participants, and results
reporting a 13% efficacy rate—a far cry from replicating Lovaas’s 47%). However, that
additional decade did yield the most comprehensive (positivist) meta-analysis to date of studies
researching the effectiveness of nonpharmacological intervention for young autistic children
(Sandbank et al., 2020), evaluating summary effects across seven different types of early
intervention models. Sandbank et al. not only tracked reported effects, but also analyzed the
included studies by prespecified quality indicators. In short, their analysis found that

when study quality indicators were not taken into account, significant positive effects were found for behavioral,
developmental, and NDBI intervention types; . . . [however, when] effect size estimation was limited to studies with
randomized controlled trial (RCT) designs, evidence of positive summary effects existed only for developmental and
NDBI [naturalistic developmental behavioral intervention] intervention types. (p. 1)

Interestingly, these data are perfectly consistent with Levy et al.’s assertion that applied
behavioral intervention research often reports significant positive effects when both “rigorous
and sometimes not-so-rigorous quasi-experimental designs” are taken into account, or as
Sandbank et al. characterize it, “when study quality indicators [are] not taken into account” (p. 1,
emphasis added). When the particular quality indicator of RCT designs was taken into account
(thereby eliminating many studies not meeting this criterion from their analysis), “evidence of
positive summary effects existed only for developmental and NDBI intervention types,” thus
providing evidence of positive effects based upon the “more rigorous trials of their efficacy” that
Mandell et al. claim to have been “eagerly await[ing].” Whether these more rigorous trials of the
efficacy of developmental models will lead any behavioral researchers to endorse those models
based upon this more rigorous scientific evidence remains to be seen; however, given Sandbank
et al.’s final analysis, that “when effect estimation was limited to RCT designs and to outcomes
for which there was no risk of detection bias, no intervention types showed significant effects on
any outcome” (p. 1), any such endorsements seem unlikely to be forthcoming (from anyone who
does not profit from developmental models of intervention).
It is necessary and appropriate that positivist claims to effectiveness of intervention be
evaluated using positivist criteria, and both meta-analyses (e.g., Sandbank et al., 2020) and
positivist methodological critiques (e.g., Gernsbacher, 2003; Dawson & Gernsbacher, 2010)
make important contributions to the processes by which experimental science proceeds. Indeed,
one may question whether Smith et al.’s (2000) study (the only RCT study of ABA’s
effectiveness to date) would have been designed and conducted as it was were it not for such
critiques coming from peers within the experimental science discourse community, particularly
the early critiques from fellow behaviorist researchers (e.g., Foxx, 1993; Herbert & Brandsma,
2001; Herbert et al., 2002; Kazdin, 1993; Schopler et al., 1989). However, all of these analyses
and critiques are also positioned squarely within a positivist worldview and experimental
methodological tradition; in addition to these, much broader and deeper critiques are in order,
ones that raise questions beyond issues of whether a particular study or studies constitutes true,
valid, or legitimate scientific proof when judged solely against the circumscribed definition of
science as experimental, treatment-effect studies with randomized assignment to treatment and
control groups. Yes, these questions are crucial; they are also insufficient. Science does not
unfold in a vacuum; it is practiced and performed within a political economy.

Moving Beyond Positivist Critique

If the analysis presented in Chapter Four serves to frame a critical analysis of the purported
“ends to be achieved” within the conceptual apparatus of the AIC for the early education of
young autistic children (i.e., “recovery” from autism), the analysis presented in this chapter
serves as its complement—toward framing a critical analysis of the advocated “means of
achieving those ends” (i.e., the purportedly “scientific” ABA intervention). By analyzing the
ways in which the discourse of scientism in ABA texts serves to rhetorically bolster claims to the
legitimacy and neutrality of advocating for the widespread use of ABA as early intervention, I
have sought to critique as inherently political a stance argued by its advocates to be without
position (i.e., nonideological)—undergirded by a neutral, natural, and taken-for-granted
assumption of its own neutrality and legitimacy. Thus, while my critique is inherently (and
unashamedly) an ideological one, so, too is the claim that a stance advocating for ABA
intervention is nonideological.
The aforementioned positivist critiques of Lovaas and other behaviorists’ claims as to the
scientific legitimacy of widespread ABA intervention for young autistic children are insufficient,
precisely because they fail to name and address the most significant ethical concern raised by
Martin as well as the fifth sign of scientism identified by Haack: namely, that scientistic (as
opposed to scientific) claims tend to look exclusively to the sciences for answers to questions
that are beyond the scope of science and that attempting to assert “scientific” answers to
fundamentally extrascientific questions is likely to be an exercise in the deployment of rhetorical
and political (and potentially economic) power and should therefore be subjected to appropriate
additional kinds of scrutiny on these bases.
The meanings behind rhetorical constructs such as “recovery” from autism as a desired end
or ABA as being “scientifically proven” to work as a means of achieving that end are also
fundamentally moral, political, ethical, and ideological, and they require examination through the
additional intersecting lenses of rhetoric, ethics, cultural politics, and economics, to name only a
few. A common rejoinder to the claim that ABA “works” argues that it doesn’t matter if it does if
the practice is unethical, inhumane, or unjust. Thus, political, advocacy, and activist stances have
often argued against the field of ABA practice on the grounds that it violates basic ethical tenets
(Sequenzia, 2016). And although applied ethicists have historically been a bit of a mixed bag in
relation to autistic people (e.g., not even necessarily acknowledging all autistics as people, or
“persons”; Simkulet, 2013), recently Wilkenfeld and McCarthy (2020) offered a comprehensive
and long-needed ethical analysis of ABA intervention for young autistic children, and in it they
argue “that a dominant form of Applied Behavior Analysis (ABA), which is widely taken to be
far-and-away the best ‘treatment’ for ASD, manifests systematic violations of the fundamental
tenets of bioethics” (p. 31). Furthermore, the authors argue that “employing ABA violates the
principles of justice and nonmaleficence and, most critically, infringes on the autonomy of
children and (when pushed aggressively) of parents as well” (p. 31). These ethicists acknowledge
that this very charge has long been advanced by autistic people, and whether one concurs with
the assertion or not, the contention itself should serve as ample indication that the ends pursued
through ABA intervention (or any other form of intervention in relation to autistic people) are far
from fixed and clear, but rather are both complex and contested, and therefore, not a matter to be
decided solely by the instrumental application of positivist tests of “scientific” efficacy.
Scientific inquiry is only one piece necessary to developing social policy, particularly in
response to complex social circumstances. For example, clearly one cannot hope to develop
public health policies that might stem the tide of a deadly pandemic if one rejects a scientific
understanding of exponential viral spread (as the United States has recently learned, to our great
mortification and our profound mortal peril). However, even if/when all parties involved concede
the basic truths of the scientific and mathematical reality of pandemic viral spread, a coherent
social policy does not automatically follow. Ethical and moral dimensions are involved in the
interpretation of scientific data, and interpretation is inevitably framed by ideology, and always
by economics. What is the calculus? Who gets to decide? As Biklen (1992) argued nearly three
decades ago, “Scientific investigation can provide information; it cannot tell society how to
behave, who to value, or where its future lies” (p. 105). Science can provide information. People,
through the messy and complex and multifaceted lenses of their ideologies, their moral values,
and their ethical codes, must decide how to interpret that information, who to value, how to
behave, and ultimately, what kind of future we want to invent. And all of these mediating lenses,
through which we interpret scientific information, are ultimately exercised within relations of
(economic) power.
The spectacularly successful rebranding of ABA during the 1990s exercised enormous and
enduring political and economic power. Autism itself was successfully commodified, and the
markets, consumers, and legitimacy of the intervention industry were manufactured on a massive
scale. By the turn of the century, this rebranding had successfully advanced a conceptual
apparatus (a) in which autism came to be almost universally understood to be a tragic and
catastrophic social problem, with the only rhetorically possible hopeful future involving ableist
visions of “recovery” from autism, and (b) in which the cultural logic of intervention came to be
hegemonic (of course autism requires intervention), and further, in which the specific
intervention of ABA had been effectively marketed as the only “scientific” (and therefore only
legitimate) intervention option. And all of this has been widely accepted in the public
imagination as natural, common sense, and taken for granted. These claims no longer require
legitimation; rather, the burden of proof commonly falls to anyone who would contest these
claims to “disprove” the “science,” and the contestation alone risks accusations of being anti-
scientific. These rhetorical accomplishments are the “patterns and plans that orchestrate
possibilities” (Dolmage, 2018, p. 2), and also, and significantly, the patterns and plans that
foreclose alternative possibilities. And they are also what Dolmage calls “scarily effective.”
The dangers inherent in the military industrial complex do not merely consist in the existence
of the arms industry generally, nor in the specific corporations that profit from it (e.g.,
Haliburton, Boeing, etc.). Rather, the danger of the military industrial complex consists in the
successfully advanced conceptual and ideological apparatus by which a majority of the American
electorate now finds it natural, normal, and taken for granted that gargantuan percentages of our
federal tax revenues should “of course” be spent on military spending, to the point that virtually
no argument or justification needs be made in order for the money to be appropriated and the
(privatized) profits to accrue. Similarly, the danger in the AIC consists in the attainment of
hegemonic (i.e., natural, normal, taken for granted) status for these claims: that autism is bad,
that intervention is necessary, that only one particular brand of intervention is “proven,” etc.
These claims are now cultural background—they are the stuff of dependent clauses, not
declarative assertions that require argument, illustration, persuasion, or proof. Spending
gargantuan amounts of money on an industry that aims to “recover” people from autism (and
privatizing many of those profits, although a substantial share of the revenue in fact comes from
public dollars), rather than spending some larger portion of that money on mitigating the
discrimination and lack of full access to civic participation that many autistic people experience
is a political, cultural, and civic decision; it is not merely an individual decision made by private
citizens. And yet the ideological apparatus of the AIC shrouds these important cultural and civic
decisions in a cloak of invisibility, even as it simultaneously obscures the prioritization (and
privatization) of public funding for ethically problematic ends.
Following the skillful rhetorical deployment of the politics of both hope and of truth, the
behaviorists deployed a final, powerful salvo in their terraforming of the contours of the autism
intervention marketplace—the politics of fear. Hope may inspire. Science may persuade. Fear
mobilizes funding.

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CHAPTER SIX

The Politics of Fear:

The Fires that Forged the Economic Apparatus of
the AIC

U P UNTIL THE LATE 1980s/early 1990s, the primary rhetorical register in which ontological
claims about autism were being deployed for parental and general public consumption had
been that of competing visions of hope. Fear had occasionally been deployed as a rhetorical
tactic during these decades, but usually on an interpersonal level and not as a widespread media
or messaging strategy. However, following Lovaas’s (1987) rebranding publication and rapidly
accelerating throughout the 1990s, ABA’s rebranded and broadly marketed vision of hope was
conceptually defined in symbiotic opposition to a very particular vision of fear: the rebrand
rhetorically positioned “recovery” from autism (the hope) against the spectral prospect of
“lifelong institutionalization” (the fear). In stark contrast to Kanner’s (1943, 1971)
conceptualizations of autism as a unique and only recently recognized form of shared human
experience that was worth better understanding, the ABA industry recognized that in order to
effectively scale up operations, autism itself needed to be feared, and not only by parents of
autistic children, but by everyone. This is further evident, for example, in Maurice’s (1993)
repeated representation of autism in her memoir as catastrophic, tragic, and hopeless. And while
parents of autistic children were no doubt a significant proportion of the readers who purchased
Maurice’s text, every parent of an autistic child in the country buying a copy would still not have
been nearly enough to catapult the title to the top of the New York Times bestseller list. Maurice’s
memoir was marketed to a wide, general audience. And it sold like hotcakes.

The Autism Culture Wars

During this time, the fearmongering integral to this branding and marketing strategy actually
appears to have (however inadvertently or unwittingly) rapidly escalated the scale of ontological
conflicts over what autism is, what it means, and who gets to say, from scattered cultural
skirmishes to widespread culture war conflicts. Behaviorists had been marketing ABA as a
source of hope for decades and had successfully commodified autism, but the autism intervention
industry continued to serve a relatively small market. During this time, behaviorists seem to have
recognized the truth of Hunter’s (1991) assertion about culture war conflicts: “The struggle to
gain legitimation requires something besides positive moral persuasion. Inevitably it entails the
existence of an enemy to stand against” (p. 136). And autism became that enemy.
Hunter argued that cultural conflict was both foundational to and endemic in American
society, and that culture wars are effectively ontological:
 the power of culture is the power to name things, to define reality, to create and shape worlds of meaning. At its most
extensive reach, it is the power to project one’s vision of the world as the dominant, if not the only legitimate, vision of
the world, such that it becomes unquestioned. (p. 33)

Hunter (1991) argued that cultural conflict is always “about power—a struggle to achieve or
maintain the power to define reality” (p. 52). Thus, the power being waged in culture war
struggles and conflicts is ontological and potentially existential: it is not merely about what we
should do or how we should act, but it is, rather, more basic than that: a struggle over the right to
say what is true (and therefore, also, to have the power to dictate what we should do and how we
should act).
To win the culture war is to have questions of actions or of policies effectively align with
your worldview, and if your victory is decisive, the very underlying conflict itself becomes
invisible, erased, nonexistent—it is to have successfully advanced your conceptual apparatus. If
you define the world, and hence the nature of reality, and thereby exercise the power to frame
problems, issues, and debates, you also control the narrative and the script. Ontological
dominance yields both policy and legislative dominance, to be sure, but those with the ability to
shape not only public policy but also public culture wield far-ranging existential power:
The right to shape the public culture, or at least the right to have a voice in how public culture will be shaped, confers
enormous benefits . . . . Those who have no voice may be defined as illegitimate—and their interests may be deemed
irrelevant. The very survival of minority moral communities is at risk unless all have the right to help shape public
discourse. (Hunter, 1991, p. 56)

By the mid-1990s, autism had become a culture war issue. Disagreements became skirmishes.
Conflict became battle. Opponents became enemies. The autism culture wars stoked the fires
within which the economic apparatus of the AIC was forged. And neoliberal capitalism scaled up
the building of the architecture of the AIC, in no small part through its willingness to dabble in
apocalyptic thinking and fearmongering—to either simply opportunistically capitalize upon or
even to cynically precipitate states of exception, crises, disasters (if that’s what it takes to
generate favorable market conditions).
Let me be clear: fear of disability (and therefore, of disabled people) has long been a
widespread cultural phenomenon, throughout human history and across most global cultures
(Baglieri & Shapiro, 2017; Davis, 2017; Dolmage, 2018). I am suggesting here that the cultural
fear of autism in this case was purposefully amplified and deliberately deployed utilizing
corporate media outlets and PR initiatives, as part of a large-scale branding and marketing
strategy, in order to create and to scale up a market for, and ultimately to generate profit from,
autism intervention services (and, less transparently, but additionally, funding for autism
prevention research).

Enter Disaster Capitalism

I have already described the events of the late 20th and early 21st centuries as jumpstarting,
turbocharging, or adding rocket fuel to the growth and proliferation of the AIC, and thereby to
the profit-generating autism (intervention, prevention, diagnostic, etc.) industries. And if the
behaviorists had already skillfully been deploying hope as a branding tactic for decades, the
game scaled up further when the capitalists even more skillfully deployed fear. Fear had not been
a core feature of early 20th century American capitalism (beyond the worker’s basic fear to
maintain access to wage labor in order to survive, thereby grooming the docility of the labor
force). However, by the 1990s, neoliberalism was well-entrenched as a hegemonic economic
ideology in the United States, the U.K., and, thanks to interventionist U.S. policies abroad and a
network of global development projects backed by the World Bank and the International
Monetary Fund, also across the globe. Naomi Klein (2007) analyzes Milton Friedman’s
articulation of what she calls “contemporary [neoliberal] capitalism’s core tactical nostrum,”
which she calls “the shock doctrine” (p. 7). Klein writes that Friedman observed that:
Only a crisis—actual or perceived—produces real change. When that crisis occurs, the actions that are taken depend on
the ideas that are lying around. That, I believe, is our basic function: to develop alternatives to existing policies, to keep
them alive and available until the politically impossible becomes politically inevitable. (Friedman, cited in Klein, p. 7)

Only a crisis—actual or perceived—produces real change. And when that “crisis” occurs (or is
manufactured), actions taken depend on the ideas lying around. What if one has ideas lying
around that aren’t yet proving to be quite so lucrative as they might be? What might happen if
the perception of crisis were actively created, or at least purposefully accelerated and amplified
—how might that affect the actions taken and the fate of one’s ideas (and products) in an
ostensibly “free” (neoliberal) marketplace? Puar (2017), discussing Klein’s thesis, remarks that
the difference between disaster capitalism and capitalism could be said to be “nonexistent” (p.
87). Further, Puar argues that “capitalism thrives on the shocks to the system and profits from
sustaining crisis as a normative state, both bodily and economically” (p. 87). Capitalism thrives
on shock and profits from crisis. This observation is consistent with the capitalists’ deployment
of fear in the AIC: the bodily crisis is the mere existence of the ever-increasing numbers of
autistic bodies; the economic crisis is literally the sticker shock that stems from imagining what
those bodies will “cost.”
Behaviorist ideas had been lying around for decades. No one was buying many wireless or
keyed shockers. However, behaviorists had been methodically building a conceptual apparatus
for years, one that was beginning to border on the hegemonic. Autism had been successfully
commodified, but the products derived from that commodity (ABA intervention products and
services) didn’t yet have large-scale markets. Lovaas initiated the rebranding campaign with his
1987 treatment-effect study and his powerful deployment of the notion of “recovery [to
normalcy]” from autism. That got the ball rolling. Maurice expanded and scaled up the branding
campaign by popularizing that idea with parents and the general public and then inextricably
linking the idea of recovery with both the intervention of ABA and the legitimacy of modernist
science. That made a huge impact. Some of this rhetoric became institutionalized in government
policy documents. That carries weight. The brand (of ABA intervention) is viable, even
attractive. It’s regarded as legitimate. Perhaps it’s time to dial it up, rather than tone it down.
What very efficiently turns potential consumers into actual ones, even more so than hope? Fear.
Enter the capitalists.

Autism Speaks and the Autism Culture Wars

When Autism Speaks formed as a nonprofit corporation in 2005, its debut simultaneously
launched a blitzkrieg of branding, marketing, and public relations media activity, all deployed in
service of furthering its policy agenda. Its rhetoric nearly uniformly anthropomorphized autism
as a foreign, alien invader; as an insidious, predatory child abductor; as the enemy. Autism is
bad, it is catastrophic, and it is coming for your children. Another spurious tactic was to cast
autism as a “disease” that appeared to be rapidly spreading by as-yet-unknown mechanisms and
that so constituted an “epidemic,” and therefore a “national public health emergency.” The
rhetorical point, in each of these cases, is simple and straightforward: to gin up fear of autism
(which also unfortunately yields the collateral damage of ginning up fear of autistic people, but
no matter—every victory comes at a price). And that price was more than offset (in some
estimations) by the millions of fundraising dollars that the fearmongering was generating.
There is nothing new or innovative about such rhetoric—in fact, it’s drawn virtually play by
play from a tried and true political playbook that engages in the systematic demonizing of
particular populations in order to generate popular sympathy and support for particular
legislative or policy positions, generally those that infringe upon the rights of minoritized
communities (and, often, that simultaneously create opportunities for private and corporate profit
generation). Recall the so-called caravan that was coming to the U.S. southern border, rhetoric
purposefully deployed to justify egregious immigration policies during the Trump administration
that included the actual (not metaphoric) abduction (by the U.S. federal government) of migrant
children from their parents (and privatization of detention facilities). Time and again throughout
U.S. history we have seen the deliberate deployment of fear of some “other” as a motivating
force to justify and generate popular public support for a policy position that might otherwise be
difficult to defend or to appropriate funding for, that might simply be a bridge too far for many
people. What are Americans afraid of? Child abductors. Epidemic contagion. Foreign, alien
invasion. (And frankly, anything that’s outside their/our own experience . . . ).
This launching of what we called in Chapter One the rhetorical equivalent of a cultural
carpet-bombing campaign is Autism Speaks’s skillful deployment of what Klein (2007) called
neoliberal capitalism’s “core tactical nostrum”—the shock doctrine. Friedman’s observation had
been that only a crisis produces actual change, and if there is not “really” a crisis and one wishes
to precipitate significant change in policy, then perhaps it’s time to manufacture a perceived
crisis. And who better to produce (corporate-media-style) and coordinate the manufacture of that
perceived crisis, that state of exception, than NBC Universal’s media mogul Bob Wright and his
wife Suzanne, cofounders of Autism Speaks.
By 2010, Autism Speaks (after a mere five years’ media monopoly and aggressive policy
lobbying) had largely seized control of the cultural narrative and the script about autism, and at
that time the central hegemonic narrative (dominated by the injection of a healthy dose of fear
into existing deficit-based rhetoric and narratives about autism) effectively constituted autism as
Public Enemy #1. Autism had always been subject to metaphoric representation. Kanner (1943)
had presented autism as a “disturbance of affective contact”; Asperger (1944/1991) as a form of
“psychopathy”; Bettelheim (1967) as a form of psychological withdrawal; and Rimland (1964)
as a specific form of “mental retardation” (1964). All of these previous metaphoric
representations related in some way to hypotheses about autism’s etiology, translated into claims
about its ontological essence—what is autism, really?
The sheer breadth and scope of the reach of Autism Speaks in its first five years constituted
an effective media monopoly, and its metaphoric representation of autism abandoned all
previous tendencies to hypothesize about etiology or ontological essence—all that mattered was
that autism be consistently cast as dangerous, threatening, sinister, bad, and coming for your
children. Thus, favored metaphors included autism as child abductor and autism as epidemic
disease (Broderick, 2010; Broderick & Ne’eman, 2008; McGuire, 2016). Obviously, autism is
not an anthropomorphized entity that steals children in the dead of night, nor is it a disease that
can be transmitted as though a virus in epidemic patterns of contagion and spread. These
metaphors are nonsensical on their face; and yet, they were propagated at every turn, relentlessly,
consistently, with clear, disciplined, and orchestrated strategy and purpose. Autism Speaks’s
media monopoly of the first decade of the century, metaphorically framing autism in these ways,
served the primary cultural purpose of constituting autism as a cultural threat significant enough
to warrant particular—aggressive, even militaristic—approaches toward both intervention (e.g.,
attempts at “recovery” through ABA intervention) and also prevention (e.g., attempts to
eliminate autism in the future, which of course means eliminating the potential future existence
of autistic people). This rhetorical monopoly served the secondary cultural purpose of generating
a strong enough sense of cultural urgency to garner widespread support for acting with
expediency and all deliberate speed in pursuit of particular legislative and policy initiatives that
advance those intervention and prevention efforts (Broderick, 2010). This rhetorical production
served to manufacture the state of exception that would constitute the pretext for the policy and
legislative agendas that would be pursued, lobbied for, and ultimately, successfully rolled out
through the advocacy efforts of Autism Speaks. These were significant rhetorical culture war
victories.
However, these metaphorical representations of autism appear, ultimately, to have been
deployed in service of capital. The creation for mass consumption of these rhetorical products (of
autism as a dangerous, threatening ontological entity that should rightfully strike terror in any
parent’s imagination, and of its twin, the cultural logic of behavioral intervention as the “only”
“scientific” response to autism) was pursued not merely in advance of a particular legislative or
policy agenda, but also in advance of particular market and commercial agendas. If money is to
be made on autism (and within neoliberal capitalism, everything is fair game to harvest for profit
—of course money should be made from autism), then the capitalists need to lend their
experience and expertise to the enterprise. The behaviorists had been muddling through on their
own for several decades—they were peddling hope (a product that always has a market of
willing consumers), and even manufactured a brilliant rebrand of the hope that their intervention
products and services could offer—the hope for “recovery” from autism.
Operant behaviorism itself had a fairly strong pedigree in Skinner and track record through
his initiatives of marketing the common-sense nature of behaviorist concepts (and the products
and services grounded in those concepts) directly to the American consumer. However, Skinner
was far from a neoliberal capitalist, and even Lovaas’s rebrand, following on the heels of the
successful commodification of autism and making a crucial contribution to the foundations of the
AIC (by constituting the hoped-for “recovery” from autism as the idealized hope and
inextricably linking it with the intervention product, ABA), was nevertheless in and of itself
insufficient to establish a large-scale and highly profitable autism intervention industry. Lovaas
sought to market his concept of “recovery” from autism primarily to the parents of autistic
children and to his behaviorist colleagues and others in interventionist professions. The
capitalists had a much further-reaching vision of the market, and they were much more skilled in
the art of bringing latent consumers to the point of active consumption. Hope may drive
aspirational cultural politics, but fear drives both policy and legislative agendas, and through
those mechanisms, public spending. How do you get the federal government to cough up
substantial sources of funding for your policy or commercial initiative? You rhetorically create a
cultural enemy, declare a “war” on it, and lobby the government to dedicate federal dollars to
combating the egregious societal ill you’ve identified.
Among the first major policy accomplishments of Autism Speaks as an advocacy
organization was its successful lobbying for the passage of the federal Combating Autism Act in
2006. However, this was not merely a policy, legislative, or lobbying accomplishment. Autism
Speaks was successful in advancing its policy and legislative agenda precisely because it
operated (and operates) as a content producer and media empire. This is consistent with Anne
McGuire’s (2016) analysis, War on Autism: On the Cultural Logic of Normative Violence. In this
text, McGuire concurs that the first decade of the 21st century was characterized by “the
repetition of very organized and very limited cultural scripts” about autism, including the casting
of autism as “pathology . . . cost . . . epidemic . . . threat . . . problem . . . [and] an illness needing
to be stopped, cured, fixed, eliminated” (p. 19). The second component of these limited and
ubiquitous cultural narratives and scripts about autism that McGuire reports noticing was the
“militaristic rhetoric” (p. 20) that pervaded this cultural discourse. McGuire’s analysis seeks to
“make legible an underlying logic: a powerful and ubiquitous logic that casts autism as a
pathological threat to normative life, and advocacy as that which must normalize, neutralize, or
otherwise eliminate this threat” (p. 21). Further, through her detailed analysis of this underlying
cultural logic, McGuire shows “how dominant, contemporary discourses of autism advocacy . . .
narrate autism as some ‘thing’ to be fought, combated, or otherwise warred against,” and thereby
provide the necessary “conditions of possibility for normative acts of violence” (p. 20).
All of this militaristic and violent rhetoric casting autism as enemy and virtually ignoring the
existence (let alone the perspectives or agendas) of autistic adults succeeded in doing one
significant and very consequential thing: This rhetorical fear-mongering fueled and stoked the
cultural fires within which the economic apparatus of the AIC was forged. These militaristic
rhetorical devices are not merely ideational (rhetoric never is): their targeted and strategic
deployment created economic and legislative and bureaucratic architecture, structures that
themselves institutionalize particular conceptualizations of autism while simultaneously
obscuring and even precluding the possibility of others. In order to profit from autism on a large
scale, it is necessary that the AIC accomplish the widespread cultural establishment of autism as
an enemy formidable enough to warrant (and fund) all-out cultural warfare against it. Thus, the
Autism Culture Wars forged the economic, legislative, and policy architecture necessary to
support and suspend the (profit-generating) autism intervention and autism prevention industries,
each of which will be explored in detail in Part Three.

On Utopia and Blank Slates

Aydarova (2019), writing about teacher education reform, specifically, as a form of political
theater, notes that the “modernization dramas” of education reform around the world commonly
“seek to destroy political possibilities,” and instead, “attempt to create economic utopias, most
conducive to corporate and oligarchic prosperity” (p. xxiii). The road to utopia often goes
directly through the orchestrated destruction of other, competing, alternative political
possibilities. And the states of exception often seized upon as circumstances necessitating the
implementation of the ideas lying around that promise us utopia are as often as not themselves
precipitated by those who stand to benefit and prosper from the economic architecture that comes
packaged (two for one) with the utopic vision. What have disasters and fear to do with hope and
utopia? Surely these are unrelated and internally inconsistent ideas. Surely fear has little to do
with hope, and disasters little to do with utopia. Surely (hopefully?). Not.
Both free-market neoliberal capitalism à la Milton Friedman and operant behaviorism à la B.
F. Skinner and O. I. Lovaas have been described as utopian projects (Harvey, 2007; Klein, 2007;
Skinner, 1948). Indeed, Skinner demonstrated early on his prescience that narrative and branding
were more persuasive cultural interlocutors than scientific data when he published his self-
described utopian (though some may describe it as dystopian) novel, Walden Two (Skinner,
1948). Writing post-World War II, Skinner genuinely appeared to believe that radical behaviorist
engineering, systematically applied at the societal level, could yield a just, peaceful, and virtually
conflict-free society, and even that such social engineering could eliminate the need for money,
per se (although by replacing money with a system of “points” as currency that could be traded
in exchange for labor, his self-described anticapitalist utopia appears nevertheless to have
spawned a fundamentally capitalist ethos among his progeny, including O. I. Lovaas). It was
arguably this novel, and not his scientific publications, that led to the establishment of multiple
intentional communities in the United States throughout the latter half of the 20th century,
espousing Walden Two as their model. And while Skinner embraced the identity of being a
utopianist, Friedman’s Capitalism and Freedom (1962) has been called utopianist as a critique
(Harvey, 2007; Klein, 2007).
Curiously, one might easily argue that each of these men was among the most culturally
influential in their respective fields (of psychology and economics) in the second half of the 20th
century in the United States. This (apparent) general tendency toward utopianist thought among
American intellectual elites of the mid-20th century is mildly curious at best, though perhaps
made even more curious (or perhaps simply more obvious or commonsensical) when one
considers that these two utopianist theories were generated in the fields of economics and
psychology, respectively. Among all the social sciences, it is difficult to say which of these two
—psychology or economics—suffers the greater degree of physics envy, i.e., which suffers more
from ambitious attempts to definitively demonstrate, once and for all, that the discipline has the
rigor, legitimacy, and power of a “hard” rather than a “soft” science.
While Skinner empirically demonstrated and deeply believed that punishment is largely
ineffective, preferring to shape behavior—verbal and otherwise—through positive
reinforcement, he had several students—Lovaas among them—who regrettably appeared
somewhat impervious to this particular teaching of their mentor and who appeared not to have
heard (or at least, not accepted) Skinner’s scathing critiques of capitalism, either. And while
Skinner’s thinking arguably was genuinely utopianist in its scope and its aims, his protégé
Lovaas’s was decisively less so, restricting his utopian fantasies to what may more accurately be
called Frankensteinian fantasies of “building” individual people, not a more just or peaceful
society. However, both neoliberalism and operant behaviorism share a further element of
conceptual convergence that is not merely curious, but that may actually help us to better
understand and explain the hand-in-glove goodness of fit between the two sets of ideas as they
intersect in the AIC. Operant behaviorism, in Skinner’s utopian imaginings, was entirely
consistent with disaster capitalism—with terraforming a society through the exploitation of a
state of exception (manufactured or not). However, for both Friedman and Skinner’s protégé
Lovaas, achieving their utopian visions relied at least in part upon a curious preoccupation with
the concept of tabula rasa—literally, “blank slate,” though figuratively (one could argue),
“playing god.”
In reporting on his early work using ABA intervention with autistic children, Lovaas (1977)
states that “the goal of our research was to teach, to developmentally retarded (autistic) children .
. . language” (p. 12). Additionally, Lovaas states that, “considering the minimal behavioral
development of autistic children, we were in a sense trying to build individuals starting with a
Tabula rasa” (p. 1). Further, in a 1974 interview published in the popular magazine Psychology
Today, Lovaas argues:

You see, you start pretty much from scratch when you work with an autistic child. You have a person in the physical
sense—they have hair, a nose and a mouth—but they are not people in the psychological sense. One way to look at the
job of helping autistic kids is to see it as a matter of constructing a person. You have the raw materials, but you have to
build the person. (Chance, 1974, p. 76)
And 15 years later, in advancing with his colleague Tristram Smith a “comprehensive behavior
theory of autistic children,” they offer the following “analogy”:

[A]t the beginning of treatment, the children may be regarded as having close to a tabula rasa. In this sense they can be
considered very young persons, as persons with little or no experience, presenting the teacher with the task of building a
person where little had existed before. (Lovaas & Smith, 1989, p. 23)

Lovaas’s repeated description of autistic children as “tabula rasa” reflects an ideological

assumption that, at best, positions them as passive recipients rather than as active learners—as
blank slates upon which the therapist writes. Lovaas’s vision of hope is thus grounded in the
underlying assumption of an individual with a labeled disability as a passive object of a teaching
technology; the hope espoused rests not in any conviction to recognize the person as learner, but
rather in the effectiveness of the method as teacher. A vastly more troubling ideological
assumption (nay, explicit ideological claim in at least one instance) of these “tabula rasa”
referents is Lovaas’s questioning of and indeed outright denial of the fundamental humanity of
the individuals in question. Because (so Lovaas claims) “they are not people in the psychological
sense,” trying to “build” or “construct” a person “where little had existed before” becomes the
“task” of the “teacher.” And if this is the task, then the more “blank” the slate, apparently, the
better.
Indeed, it would appear that this desire for as blank a slate as possible upon which to work—
at least in part—may have motivated Lovaas to shift the target of his ABA intervention
technologies to focus primarily upon autistic children in the first place. (And yes, I am aware that
Lovaas would have contested my claim that he was motivated to do anything, let alone that he
had desires; he would have preferred me to discuss the behaviors he was reinforced to repeat, or
his behaviors that were extinguished due to a lack of reinforcement or due to punishment. Duly
noted. However, I stand with Bartleby in rejoining, “I would prefer not to.”) Nevertheless,
Dawson (2004), in her incisive essay “The Misbehaviour of Behaviourists,” reminds us that
Lovaas’s earliest forays into applying ABA technologies for the purposes of behavior change
were not targeted solely at autistic children; they were also initially targeted at so-called feminine
boys.
UCLA’s Feminine Boys Project (FBP) preceded the Young Autism Project (YAP) by several
years, though there was some overlap in dates of publications generated from the respective
projects. O. I. Lovaas served as principal investigator for both, although much of the FBP was
conducted with his protégé George Rekers, who pursued the line of inquiry as his doctoral
dissertation work. In later years, Lovaas distanced himself from this early work (a further
indication of his rhetorical, media, branding, and political savvy—the political fallout was toxic),
but the intervention designs were nearly identical. The FBP targeted for replacement undesired
behaviors (that is, so-called feminine behaviors) with desired behaviors (that is, so-called
masculine behaviors) in young boys. As with the YAP, both contingent reinforcement (e.g.,
praise and food) and contingent punishment (e.g., slaps or spanks) were systematically deployed,
in both projects with the stated aim of making the young subjects “indistinguishable” from their
“normal” peers. I will return to the divergent trajectories of these two ABA research projects and
their relative contemporary cultural impact later in the chapter.
However, at this juncture in my analysis, I consider whether Lovaas may have elected to
wager the preponderance of his time, labor, and professional reputation on the YAP rather than
the FBP precisely because, from his perspective, the “subjects” in the YAP appeared (to him) to
be closer approximations of the desired “blank slates” that were the raw material of his utopian,
playing-god project of “building a person” where none had existed before. The young boys
targeted for behavioral intervention in the FBP were indeed young, but they had at their disposal
verbal language, a defense mechanism that not all participants in the YAP had access to. In the
absence of much spoken language, it would have been much simpler for Lovaas to maintain his
belief in the “blank slate” of the autistic child, simply by persistently assuming that absence of
speech equates to absence of language (or of thought, or even of personhood). Thus, the young
children in the YAP probably better enabled Lovaas to regard them as more promising “raw
materials” from which to build [nonautistic, cis- and heteronormative] persons than the young
boys in the FBP did.
Curiously, Friedman’s playbook for advancing neoliberal economic reforms in the mid-late
20th century relied in a similar manner upon the notion of a blank slate, albeit on a completely
different scale. Whereas Lovaas sought as his blank slates individual autistic children as young
and as prelinguistic as possible so as to have the greatest possible impact upon their unfolding
development, Friedman sought as his blank slates not individuals, but economies—or at least
sectors of economies—so as to likewise have the greatest possible impact upon their
development. For example, in the wake of Hurricane Katrina in 2005, at the age of 93, Friedman
advised the Bush administration on a policy that effectively privatized public education in New
Orleans in one fell swoop, replacing the city’s public schools with a multitude of privately run,
many for-profit, charter schools, resourced by publicly funded vouchers but accountable to no
one but themselves. According to Klein, Friedman penned an op-ed in the New York Times
following the disaster calling it both a “tragedy” and “also an opportunity” (Friedman, cited in
Klein, 2007, p. 5). According to Klein, “the American Enterprise Institute, a Friedmanite think
tank, enthused that ‘Katrina accomplished in a day . . . what Louisiana school reformers couldn’t
do after years of trying’” (p. 6). What Katrina had “accomplished” was the literal wiping off the
map of large swathes of New Orleans neighborhoods, including much of its public school
system. Katrina created in New Orleans a “blank slate” upon which the educational system could
be not reformed or repaired, but remade—built virtually from scratch and in a manner that
economically benefited the plutocratic investor class (charter schools are lucrative). Katrina
provided the Bush administration with a tabula rasa—the opportunity to build an effectively
privatized school system where a public one no longer existed.
Thus, each of these utopianist schools of thought, in their respective disciplines of
psychology and economics—one concerned with individuals, the other with economies and
societies—in the late 20th century hungered for blank slates upon which to build their
masterpieces, make their marks. Imagine if the pursuit of the social sciences were unfettered by
the vagaries of human history, unencumbered by the messy complexity of the existing people
actually purported to be studied, understood. Imagine the power of the behaviorist or the
economist who gets to say, on the first day, “Let there be light.” And this is the problem with
pining for tabula rasa. Seeking and exploiting tabula rasa reveals a fundamental desire not to
understand (what is there to understand from nothingness?), nor even to predict (what relevance
has prediction when one directs and creates the outcome?), but rather to impact, influence, shape,
and control. Now imagine if the goal were to understand, rather than to influence or control. If
the goal were to understand—or even to predict—human behavior, or economics, then tabula
rasa would actually undermine that goal by limiting the richness of the information and the data
available to be studied, analyzed, interpreted, understood. Thus it would seem that understanding
is perhaps not the goal after all.
 Diagnostic Subsector: Manufacturing the “Slates”

Ian Hacking (2009) noted what many others had in the first decade of the century: “Hardly
anyone had heard of autism before Rain Man in 1988, some 20 years ago” (p. 46). And while
everyone today not only has heard of autism (due in no small part to the early labors of the AIC),
but also knows something about autism (or thinks they do), most people probably also know an
autistic person (or two, or 10). But where did all these autistic people come from? In response to
the rhetorical questions, “are there really more autistic children born every year than ever before
in history? Are the amazing increases in reported prevalence due to an epidemic of autism?”
Hacking unequivocally responds “My answer is no” (p. 49), an assessment with which I heartily
concur. Rather, Hacking contends that

The increases are thanks to expanding criteria of diagnosis, much greater alertness on the part of primary-care physicians
and teachers to the possibility of autism, and to the fact that a diagnosis of autism gets a troubled child much better care
for special needs than any other diagnosis. (p. 49)

In so dismissing the narrative of there being an autism “epidemic,” Hacking’s argument aligns
with many other scholars and scientists who have already provided us with granular analyses of
the relevant data sets and cultural/historical contexts often cited as the basis of such claims (e.g.,
Gernsbacher et al., 2005; Grinker, 2007; Shattuck, 2006), each of whom disputes or outright
rejects the (admittedly quite effective) rhetorical narrative of the “autism epidemic.”
One can only hope that—from the vantage point of 2022 and with benefit of hindsight, and
having regrettably experienced an actual epidemic and indeed global pandemic in the meantime
—the rhetors who seeded the hyperbolic narrative of an autism “epidemic” may now (perhaps)
feel some sense of regret, some recognition of overreach, some cognitive or ethical dissonance
with that tactic. However, that seems unlikely to me, given how remarkably effective the tactic
itself proved to be, just as many of the other fear-mongering rhetorical tactics of the 1990s and
early 2000s had. Effective at what? Effective at scaling up the production of one of the basic
foundational commodities of the AIC—autistic people. Lovaas himself described autistic
children in a psychological sense as “raw materials” from which he aimed to “build a person.” It
turns out one of his legacies (wittingly or not) has been to constitute autistic children as raw
materials in an economic and commercial sense as well—as commodities.
The AIC’s foundational rhetorical and ideological work was to commodify autism, and it did
so with remarkable success, yielding an extremely flexible commodity that can form (and has
formed) the foundation of an almost infinite variety of commercial transactions. However, at a
basic level (simultaneously, somehow, both mundane and obscene), it was also necessary for the
AIC to commodify on a large scale the bodies of autistic people. Scaling up the economics of the
autism industries required, quite simply, that there be more autistic people whose bodies could be
sites of deployment of the latest intervention technologies: more “blank slates” upon which to
write, from which to “build a person”—more commodities to harvest and markets to capitalize
upon.
Grinker (2020) argues that this “particular diagnosis [autism] became embedded in a
financial system that has come to depend on that diagnosis for its sustainability and growth” (p.
7). Similarly, McGuire (2016) describes the AIC itself as comprising “public and private
investment interests that benefit economically from, and indeed whose very fiscal survival is
reliant upon, the existence of” autistic bodies (p. 126), though I would argue that description is
more aptly applied to the autism industries, not the AIC. The fiscal growth, sustainability, even
survival of the autism industries is dependent upon the diagnostic production of the very autistic
bodies that form the foundational commodity of those industries. Grinker (2020) has discussed
this connection between this commodity and the circulation of capital in relation to it at some
length:

As Ian Hacking and others have so lucidly described, once a diagnosis takes hold and serves as the hub around which so
much wealth, so many people and activities coalesce, it takes on a life of its own as an authentic, naturalized classification
(Hacking 2000). This category, in turn, provides an incentive for manufacturing people with the diagnosis of autism
whose presence and needs support this financial infrastructure. (p. 9)

However, the ways in which a “diagnosis” such as autism “takes hold” is perhaps somewhat
more banal, prosaic, and incremental than the ways in which the sensationalist rhetorical
narrative of an “epidemic” functioned to rationalize (and subsequently generate ongoing funding
for) particular intervention and research priorities.
As Yergeau and other scholars have long argued, autism is a profoundly rhetorical
phenomenon (Heilker & Yergeau, 2011; Yergeau, 2017). A number of scholars have already
offered nuanced accounts of the ways that both bureaucratic and legislative changes have had a
significant impact on our accounting, and one might argue the rhetorical creation, of autistic
people (Grinker, 2007, 2020; Shefer, 2018 ; Silberman, 2015; Singh, 2016; Yergeau, 2017); I’ll
offer here a brief and truncated historical timeline of those events. Chapter Two explored
Kanner’s initial constitution of autism as an ontological category in the United States in 1943,
and less than a decade later, in 1952, the second edition of the Diagnostic and Statistical Manual
of Mental Disorders (DSM-II) included autism as a psychiatric diagnosis. As such, it was
relatively rarely applied, and then primarily to children at risk of institutionalization (or to those
already subjected to it), and therefore under the care of a child psychiatrist. However, in the
DSM-III, in 1980, autism was reclassified as a developmental, rather than psychiatric, disorder,
and pediatricians therefore became increasingly involved in screening for autism among their
young patients, rather than it being within the exclusive purview of a child psychiatrist.
Nevertheless, the DSM-III criteria for an autism diagnosis at the time remained fairly narrow, in
alignment with Kanner’s early descriptions, and relatively few children qualified for an autism
diagnosis, though the numbers were starting to increase with the more routine involvement of
pediatricians. In 1987, the revised DSM-III-R began to broaden the criteria for an autism
diagnosis, including by adding a catch-all subset diagnosis for kids who met some, but not all, of
the criteria for an autism diagnosis (termed “Pervasive Developmental Disorder, Not Otherwise
Specified,” or PDD-NOS), and by eliminating the requirement that onset of “symptoms” occur
prior to 30 months of age, thus enabling more and more school-age kids to fall within these
broadened diagnostic parameters.
In 1990, autism was added to the Individuals with Disabilities Education Act (IDEA) as a
qualifying category of eligibility for special education services, so the diagnostic gaze became
even more broadly bureaucratically distributed, and thenceforth included not only pediatricians,
but also educators in public schools (operating under IDEA’s “Child Find” legal mandate to find
and document disabled children in public schools), and increasingly, parents, as advocates for
their own children. Thus, in the late 1980s and early ‘90s, in articulation with the watershed
rhetorical moments of Lovaas’s 1987 treatment-effect study and Maurice’s (1993) memoir, these
dynamics shifted even further as more and more parents sought autism diagnoses for their
children in public schools. In the course of only a few decades, an autism diagnosis had
rhetorically shifted from being something most parents may never even have heard of (and even
if you had, most likely filled you with dread at the prospect of its being attached to your child) to
being something that was actively sought by many parents as a desired diagnostic set of
documentation for your child. Because an autism diagnosis was a ticket, one that in the 1990s
came to signify and deliver access to higher levels of supports and services (in schools) than
most other disability labels.
In 1994, the updated DSM-IV was released, once again reconceptualizing autism, this time as
a “spectrum” disorder, with vastly more flexible and expansive diagnostic criteria, thus casting a
much wider diagnostic net and “diagnosing” and “qualifying” many more kids who would not
have “been” autistic under earlier diagnostic criteria for autism (a profoundly and actively
rhetorical phenomenon). Indeed, the broadening of the diagnostic criteria for “autism spectrum
disorder” (ASD) gives the appearance of having operated as a sort of test balloon for similar
conceptual broadenings or reframings of other diagnoses that were to occur in the subsequent
edition, the DSM-V, in 2013, including, for example, “schizophrenia spectrum disorders, bipolar
spectrum disorder, and the depressive spectrum” (Grinker, 2020, p. 3). Having first established
the “spectrum” conceptualization for autism in the DSM-IV, the DSM-V tidied up its diagnostic
criteria a bit by removing several subsets of diagnoses that had been added in its previous
editions (e.g., PDD-NOS and Asperger Syndrome), collapsing all of it under the very broad
umbrella concept of ASD. The subsequent patterning of other diagnostic categories after the
successfully beta-tested expansion of autism into a “spectrum disorder” suggests that the gambit
was apparently regarded as a success (by whom, and at what, one must then ask). In pointing to
the remarkable rate of growth (cast as “epidemic”) in autism diagnoses in the United States (as
well as that of ADHD, etc.), Grinker (2020) incisively reminds us that such diagnoses are
increasingly “linked to extensive financial interests” (p. 6), including, but not limited to, for
example, the pharmaceutical industry, and in the case of autism, also the behavioral intervention
industry.
Grinker (2020) cogently puts his finger on one of the most significant factors driving the
increase in autism diagnoses, particularly in schools under IDEA, when he observes, “Fiscal
incentives and disincentives play an important role in the number of school diagnoses of autism:
the more diagnoses, the more money the school receives (Sigafoos et al., 2010)” (p. 7). Grinker
argues that it is within schools that the diagnosis first came to have the greatest “financial
significance” (p. 7), and describes autism as a diagnosis that has become “increasingly desirable
as a replacement for other diagnoses” (p. 7), reminding us that the “increase” in autism diagnoses
in schools coincided with a commensurate drop in other, potentially more stigmatizing,
diagnoses:

Between the 2000–2001 and 2010–2011 school years, autism classifications in the American public school system rose by
331%, but the proportion of children in special education programs in the public schools remained static (Polyak, Kubina,
and Girirajan 2015). A static special education rate and an increase in autism can occur only if other classifications drop.
(p. 7)

None of these seemingly mundane bureaucratic and rhetorical machinations are new. A very
similar trajectory (only a couple of decades earlier) had rhetorically constituted the (persistently
dubious) diagnosis of “learning disability” and the professional industries that diagnosis spawned
(Coles, 1989; Danforth, 2009; Sleeter, 1986), and the largely school-based diagnosis of Attention
Deficit Hyperactivity Disorder (ADHD) was similarly launched in articulation with the highly
lucrative pharmaceutical industry and that industry’s expansion into direct marketing of its
products to the public (rather than merely to physicians).
Sheffer (2018) described the diagnostic bureaucracy in the cultural/historical context of the
Third Reich as a “diagnosis regime” (p. 18), in which the diagnostic sorting processes facilitated
by Asperger and others served the interests of the national socialist state. I argue that the
diagnostic sorting processes in the contemporary U.S. cultural/historical context function, rather,
as a diagnostic subsector (of profit-generating industries), serving the interests of private and
corporate industry in the neoliberal autism economy, by manufacturing a steady (if not ever-
increasing) supply of the foundational commodity of the myriad autism industries—autistic
people. However, in true neoliberal gaslighting fashion, none of these methodical bureaucratic
moves is presented in the media or to the general public as such. Rather, they are rhetorically
produced in the media as constituting an “epidemic” of autistic people—the precipitating state of
exception necessary to both fuel culture war politics and concomitantly to justify and fuel ever-
increasing financial investments of public dollars into the for-profit autism industries. Because
culture war politics in a neoliberal economy are always, also, about money.

Culture Wars Reprise

American culture wars have always been waged as struggles over the right and the power to
(effectively) define reality. They may appear on the surface to be ideological struggles over
particular public policies, but differing policy positions logically flow from conflicting and
competing ontological claims, and very few culture war skirmishes are actually fought on
mutually conceded ontological ground. Indeed policy debates can be nonsensical within the
theater of hot culture wars—one side’s policy position is likely incomprehensible to the other
side from within their conflicting rhetorical grammars and ontological worldviews. And since
neither side accepts the foundational ontological framing of their opponents, policy debates per
se are sometimes not even had, but rather, the battles are waged purely over the right to frame
and define the parameters of the debate. Policy victories often follow ontological victories, rather
than necessarily being won on the merits of the policy itself. Thus, to win the culture war is to
have questions of actions or of policies effectively align with your worldview, and if your
ontological victory is decisive (i.e., hegemonic), the underlying conflict of ontological claims
itself becomes less visible, possibly even invisible, erased, nonexistent. If you define the world,
and hence the nature of reality, you thereby control the narrative and the script and thereby
exercise the power not only to frame problems, issues, and debates, but also to dictate policy
without necessarily having to argue for its merit, merely having established its underlying
ontological presumptions as hegemonic and commonsensical.
So how are the Autism Culture Wars going? Zoe Gross, who is currently director of
advocacy at the Autistic Self Advocacy Network (ASAN), in the film Citizen Autistic, expressed
her hope that autism politics would follow a similar trajectory to LGBTQ politics:

There are still people out there, actually, claiming that you can cure people of gayness, but no one believes them. Whereas
there are a lot of people who are willing to believe—who are desperate to believe—that you can cure autism. I point to
the trajectory of gayness as being thought of as a cure thing, a disease thing, to being thought of as a rights thing in the
hopes that autism is going to go that same way. (Davenport, 2013)

Because of the shared history of these culturally marginalized and interrelated sets of identities
(LGBTQ, autistic, neurodivergent, neuroqueer, etc.), it can be instructive to compare the ways in
which the respective trajectories of the cultural politics have diverged over time for each of these
activist communities. Young children in both of these groups were targeted for decades by
behaviorist researchers at UCLA, in the FBP and subsequently the YAP. Both groups of children
targeted in these studies were subjected to intensive and intrusive ABA interventions, with the
express aim of making so-called feminine boys and autistic children “indistinguishable from
their [cis-het-normative and allistic, respectively] peers.” But where are they now?

Building a Person

Jake Pyne (2020) recently penned an incisive and quite useful analysis of the stark contrasts
between the contemporary clinical, legal, and cultural contexts and politics of (non)recognition
of personhood for trans and autistic youth in the specific legal and cultural context of Ontario,
Canada. Also referencing the shared history of both groups’ subjection to intensive and intrusive
ABA interventions at UCLA at the hands of O. I. Lovaas and his colleagues, Pyne notes that
Decades later, these treatments exist in radically incommensurate legal contexts. In Ontario, lesbian, gay, bisexual,
transgender (LGBT) conversion therapy was banned for minors in 2015, while the following year, ABA received $333
million in government funding (Ontario, 2016) . . . .While many autistic self-advocates refer to ABA as “autistic
conversion therapy” . . . , ABA is not only legal, but legally mandated for provision in some educational settings (Ontario
Ministry of Education, 2007). (p. 342)

Pyne explores in this analysis what he calls the “diverging threads of dehumanization” (p. 342)
underpinning each of these clinically similar treatment histories and their radically divergent
legal realities. He argues that “the process of Ontario queer and trans communities wresting
themselves out from under conversion therapy involved discursively shifting from having a
condition to being a human,” ironically invoking Lovaas’s metaphoric construct to describe this
also as “a process of building a person” (pp. 342–343). Pyne highlights what he calls the
“discursive disparity between having and being (having a condition versus being a person)” (p.
344, emphases in original) as pivotal to the divergence of these two trajectories.
Pyne’s analysis illustrates the ways in which efforts to depathologize first gay and lesbian
and later trans and queer identities required, in part, a linguistic and discursive refusal of the
syntax and rhetoric of disablement. That is, his analysis highlights the ontologically-constituting
materiality of culture war rhetoric: when syntactically and discursively constituted as youth
“with” “Gender Identity Disorder in Childhood” (thank you, DSM-III), intrusive interventions
and “treatments” such as conversion therapies and even pharmacological interventions followed
(why would one not treat a disorder?). However, in claiming queer, trans, or gay as one’s
identity, expressing “pride” and politically pursuing “liberation” and “civil rights,” activist
communities and the general public responded with solidarity—behaviorist or other therapies
that sought to “convert” a gay or trans child to “normalcy” were pushed back upon as a violation
of bodily autonomy, agency, and identity, and such practices fell far enough out of favor that
they were banned in Ontario (for queer and trans folk) in 2015. Yet Pyne points to the gross
incongruence in the near totality of Lovaas’s rhetorical (and therefore ontological) victories in
branding ABA as necessary and good for autistic people:
Despite open violence, Lovaas framed ABA as compassionate (for preventing self-harm). Despite uncertain evidence, he
presented ABA as scientific. Despite a lack of consent, he cast ABA as granting freedom (from institutionalization).
These affective and intellectual strategies have proved enduring. (Pyne, 2020, p. 347)

Pyne deftly draws a direct line from this common rhetorical history, through divergent activist
contexts, to the radically contradictory public policy and legal contexts in Ontario today. The
materiality of rhetoric is profound.
In the United States, the current status of this particular culture war is no more heartening
than it is in Pyne’s estimation in Canada. As an illustration of the divergent impact of the autism
culture war politics in the United States and the ways that they differentially impact, shape, and
frame both cultural issues and public policy, I’ll offer here a brief, snapshot, comparative, U.S.-
centric analysis of the same two groups of people initially targeted by behaviorists in the 1970s
for their tabula rasa complex of interventions, each of which Pyne (2020) similarly analyzed in
the context of public policy in Ontario, Canada: one of which (autistic people) eventually became
(and continues to be) the target of a fully-developed industrial complex, and the other of which
(LGBTQ people), notably, and thankfully, did not.

How Does it Feel to Be a Public Health Risk, Rather than a Person?

The U.S. Government’s Centers for Disease Control and Prevention (CDC)’s webpage titled
Lesbian, Gay, Bisexual, and Transgender Health (CDC, 2021c) begins with this prominently
displayed block of introductory text:

People who are lesbian, gay, bisexual, or transgender (LGBT) are members of every community. They are diverse, come
from all walks of life, and include people of all races and ethnicities, all ages, all socioeconomic statuses, and from all
parts of the country. The perspectives and needs of LGBT people should be routinely considered in public health efforts
to improve the overall health of every person and eliminate health disparities.

Juxtaposed with this block of text is a banner that reads “Learn what CDC is doing to protect the
health of LGBT [sic]: Spotlight on Hepatitis and Gay/Bisexual Men.” This banner is displayed
beneath a central, color, closeup photo of a gay couple, both presenting as White cisgendered
men, posed cheek-to-cheek, with one looking directly into the camera and the other looking off
to the side, both smiling, apparently happily. On either side of this central photo are artistically
bookended black-and-white extreme closeup shots, apparently details of the central photo, each
centered on an eye of one of the men in the central photo. By clicking the arrows, a user can
scroll through several other banners, including one that links to state-by-state health services and
resources, one highlighting HIV risk reduction, and another highlighting protective factors for
LGBTQ youth (specifically, access to informational resources for health and education
professionals tasked with protecting youth). Thus, although there are certainly elements that bear
rhetorical critique, upon landing at this webpage, one is immediately presented with a largely
positive, affirming image of LGBTQ people: they are represented as members of every
community, and as occupying diverse positionalities within those communities. They are
affirmed as valued and valuable public health constituents whose perspectives and needs should
be routinely considered not only in relation to their specific subconstituency as LGBTQ people,
but in “public health efforts to improve the overall health of every person.” Additionally, they
are positioned as both resources for and (presumably) subjects of the CDC’s efforts to “protect
the health of LGBT[Q] [people]” and to “eliminate health disparities.” Resources presented on
this page are presented for LGBTQ people, with a secondary audience being health care
providers who serve LGBTQ community members.
A similar impression is presented if one clicks on the link to “transgender persons” (CDC,
2021d): There is a clear description of the term transgender and a clear, if basic explanation of
the differences distinguishing the concepts of gender identity, gender expression, and sexual
orientation. The section titled “Resources for Transgender Persons” precedes the section titled
“Resources for Health Care Providers and Public Health Professionals about Transgender
Health.” Note also that the latter provides resources about transgender [persons’] health, not
resources about how to spot or identify or label a transgender person. The layout of the page
communicates the expectation that transgender people are the primary audience, with people
employed to serve and meet the health care needs of transgender people a secondary audience.
Resources are provided on topics including but not limited to sexual health, HIV prevention, the
bullying of transgender youth, heart disease, cancer prevention, obesity, intimate partner
violence, and suicide prevention. Again, it is clear that the preponderance of the resources
provided are aimed at either improving the health of transgender people and/or mitigating risks
to the health of transgender people (including both general risks such as obesity and heart
disease, as well as the specific risks posed by being a transgender person in a transphobic world,
such as bullying, intimate partner violence, and suicide).
By way of contrast: the CDC’s page on autism, or “Autism Spectrum Disorder (ASD)”
(CDC, 2021a). Superimposed at the top of the page is a red banner with an exclamation point
titled “Coronavirus Disease 2019: Find information and resources for people with developmental
and behavioral disabilities.” Thus, not only is autism immediately and definitively presented as a
developmental and/or behavioral disability, but people with such disabilities are the object, not
the subject, of the notation. The “you [understood]” subject (e.g., “[You] find information”) is
presumed not to be the autistic or disabled person; rather, (you) (presumably a nondisabled,
nonautistic person) (subject) find information for or about the disabled, autistic person (object).
This is our first indication that the audience for this page is presumed not to be autistic people,
but rather nonautistic people seeking information about autism as a health concern.
For access to COVID-19 resources, visitors to the page are provided direct links to Autism
Speaks, the Autism Society of America, the Autism Science Foundation (cofounded by Alison
Tepper-Singer, former executive vice president of Autism Speaks and former vice president at
NBC Universal), and the U.S. federal government’s Interagency Autism Coordinating
Committee (on which Alison Tepper-Singer has sat since 2007). The most prominent visual at
the top of the page is a colorful photo of four smiling and laughing children (presenting a
diversity of both racial and gender identities: two White children, presenting as cisgendered male
and female; and two children of color, presenting as cisgendered male and female).
(Interestingly, if you conduct a web search for this image, you’ll find over 400 other sites that
also use this carefully orchestrated image of smiling, happy diversity, many of which happen to
be sites of consultancies offering ABA intervention services as well as other governmental health
agencies’ webpages.) The text under the linked photo reads: “CDC Launches Autism Data
Visualization Tool to Improve Access to Data” (more on this link shortly). If you scroll down,
you’ll come upon text that reads:

Autism spectrum disorder (ASD) is a developmental disability that can cause significant social, communication, and
behavioral challenges. CDC is committed to continuing to provide essential data on ASD, search for factors that put
children at risk for ASD and possible causes, and develop resources that help identify children with ASD as early as
possible.

Beneath this text defining autism in this way is a series of links to resources and information on
screening and diagnosis for families and health professionals (none whatsoever aimed at an
audience of autistic people); information on treatment and early intervention services (beginning
with behavioral intervention); and information on signs, symptoms, causes, and “what to do if
you’re concerned”—the “you” here a parent of a potentially autistic child, not someone who is
exploring their own identity vis-à-vis autism; additionally, there is no rhetorical possibility
within this organization of wondering, exploration, curiosity—only of “concern.” Furthermore,
there are links to data and statistics on autism prevalence, which, via the new “data visualization
tool,” provide multiple graphs, charts, etc., documenting the increased prevalence of autism over
the years, with little to no discussion of the broadened diagnostic criteria, to say nothing of the
industrial complex, potentially driving those changes.
When compared to the CDC’s topical pages on LGBT and transgender people, specifically,
several notable and glaring contrasts become apparent. First, the CDC appears to consider LGBT
community members to be constituents of the government agency and therefore to consider it to
be its responsibility to provide current and relevant resources to those constituents about their
own health. There is no such clarity that the CDC considers autistic community members to be
constituents of this government agency, and their only (apparent) perceived responsibility
appears to be to the parents and health care providers of autistic people (primarily, autistic
children). Second, it is clear that the CDC perceives the existence of and attempts to anticipate
and meet the needs of both adult and youth members of the LGBTQ community. The
preponderance of its information is relevant to and directed at adults; however, there are
resources specific to LGBTQ youth as well. By contrast, since the preponderance of the
information presented on the CDC’s autism website is aimed at parents of autistic children, it is
not at all clear that the CDC recognizes that autistic adults even exist. Third, it is clear that the
CDC considers its responsibility to its LGBTQ constituency to be to provide information and
resources about LGBTQ people’s health, broadly conceived (e.g., regarding heart disease,
cancer, obesity, etc.), as well as information relevant to reducing or mitigating the risks to one’s
own health from living in a homophobic and transphobic society (e.g., suicide risk, bullying,
intimate partner violence, etc.). It is not at all clear that CDC perceives any such analogous
responsibility to autistic community members to provide resources and information about health,
either broadly conceived or specific to the risks of living as an autistic person in an ableist
society. In fact, apart from COVID-19-related risks (which was abdicated to outside agencies to
provide), it seems clear that the single greatest health risk and only real concern that the CDC
perceives (and therefore, feels it is within its charge to address) is the mere fact of being autistic.
There is zero information provided to autistic people about common health resources they may
be seeking, including nutritional, mental or emotional health; general health concerns such as
obesity, heart disease, or cancer; or specific risks to one’s health that many autistic people face,
including harassment, intimidation, and bullying; intimate partner violence and other forms of
abuse or neglect; increased risk of both chronic and acute traumatic stress; increased COVID-19
risk if one’s parents or guardians are antivaxxers and they control one’s medical care; and
comorbidities such as seizure disorders and Ehlers-Danlos Syndrome.
There are many additional points of comparative/contrastive analysis to be made, but I will
close with a fourth and final point: the CDC appears to present very similar prevalence data on
the prevalence of autism (“about 1 in 54;”) (CDC, 2021b) and on the prevalence of transgender
identity (about 1.8%, or approximately 1 in 55) (CDC, 2019) in youth. When lesbian, gay,
bisexual, and other queer youth are considered as well, LGBTQ identities are actually more
prevalent than autistic identities among youth. And both of these numbers (apparently rising—or
at least, our awareness and documentation of them are rising) appear to cause some concern on
the part of the CDC. The stark difference is the nature of the public health concern presented.
When the CDC published data in January of 2019 demonstrating that estimates of the prevalence
of transgender youth in schools were higher than previously estimated, the framing of the public
health implications and concern was that transgender youth were at higher risk of bullying,
violence, victimization, substance use, suicide risk, and sexual risk-taking, and that public health
agencies had not yet fully addressed the needs of this increasingly visible and potentially
vulnerable (due to being mis- or underserved by public health policy) constituency. According to
the CDC, “These findings indicate a need for intervention efforts to improve health outcomes
among transgender youths” (CDC, 2019). These intervention efforts included anti-bullying, -
intimidation, and -harassment programs for all students and school personnel, the general
creation of safe learning environments, and the overall reduction of risk for violence and
victimization. There is zero discussion on the CDC site framing the public health “problem” as
an “epidemic” of transgender youth, nor any surveillance or fearmongering discourse about
“knowing the signs” of transgender identity, or of public health or public school personnel
“identifying” transgender youth to target them for intrusive or individualized interventions
(which is precisely as it should be). The needs are presented as urgent, yes; but they are urgent
public health needs and interventions aimed at improving the health of the body politic for all of
its constituents, including particularly this group that we’ve just realized we’ve been doing a
lousy job for. There is zero hint of “interventions” aimed at transgender youth to make them
present more as cisgendered (remember the FBP?).
By contrast, the “1 in 54” prevalence data for autism is presented as an urgent public health
concern in and of itself; not because of how underserved this group of autistic students and
citizens appears to be, but simply because this many autistic people exist (which we simply can’t
have—it is cast as dangerous and problematic on its face). Because autism is exclusively framed
as disorder, disability, disease, the “intervention” is squarely and exclusively aimed at treating
autistic people with hopes of making them less autistic. Autistic people are the objects, not the
subjects, of autism-related public health concerns as framed and articulated by the CDC. Perhaps
this is (in part) what it looks like when you’re losing the culture war.
My transgender siblings should perhaps be thanking their lucky stars that O. Ivar Lovaas
relinquished his grip on his initial targets of “feminine boys” and instead trained his sights on
autistic youth as the more promising “tabula rasa” upon which he might create people with his
behaviorist technologies (and perhaps the more vulnerable, and therefore more easily harvested,
commodity for ABA’s industrial complex of interventions). It should be noted that by 1973—the
same year homosexuality was removed from the DSM as a psychiatric diagnosis—Farrall
Instruments was also directly marketing its visually keyed shocker, wireless shocker, and other
products to behaviorists and physicians for use in “medical” gay conversion therapy as well as
ABA therapies for autistic people (Mattachine Society of Washington, D.C., 2018, p. 4). Thank
goodness that industrial complex ultimately didn’t take hold.
I do not mean to imply that the LGBTQ culture wars have not been hard fought (there has
been much devastating interpersonal violence, including death, and much institutional violence,
including systematic civil and human rights violations) and hard won (following decades of
community organizing, advocacy, and activism resulting in legislative, litigative, and policy
victories), nor that there is not grave contemporary risk posed to LGBTQ people by present
culture war initiatives. Indeed, even the relatively more positive rhetorical representation in this
brief analysis of a federal website could be cast as irrelevant in the face of current relentless,
coordinated legislative initiatives in the United States. These state-level culture war bills seek, in
boilerplate fashion, to severely curtail the civil and human rights of LGBTQ people, and of trans
youth in particular (e.g., so-called bathroom laws, banning transgender youth from school sports,
denying transgender youth gender-affirming healthcare, etc.).
However, I do mean to point out that perhaps the terrain of the two, albeit overlapping,
culture wars differs in part because there is no large-scale, nationwide, hegemonic industrial
complex in which LGBTQ youth are systematically identified and commodified in toddlerhood
and salvaged to generate profit in an entrenched intervention complex. I grant that certain
subsectors of American society have been groomed to accept the naturalness and desirability of
interventions such as gay conversation therapies, and LGBTQ youth growing up in such families
and communities continue to be at considerable personal risk. However, you probably couldn’t
walk around your neighborhood or your public school and ask people to donate money to
sponsor a gay conversation walk and get most people willing to throw 10 or 20 bucks your way
and wish you well, whereas you’d probably have little difficulty getting people to agree to chip
in for an autism walk, even though the preponderance of funds will likely go to either
intervention or prevention industries and not to autistic people. In short, there is presently no
large-scale hegemonic intervention complex systematically targeting LGBTQ youth as
commodities to be salvaged for profit generation (knock wood).
Autistic scholar Michelle Dawson has also written about the eerily similar methodological
and rhetorical trajectories of these two different intervention research projects, each being
legacies of O. I. Lovaas’s research agenda at UCLA (Dawson, 2004, 2008). I have previously
discussed the methodological similarities of these two intervention projects (e.g., the contingent
reinforcement of “nonfeminine” behavior in boys and “nonautistic” behavior in autistics, coupled
with the contingent punishment of either “feminine” or “autistic” behavior in the respective
targets of intervention). However, the rhetorical justification for subjecting so-called feminine
boys to ABA intervention was also remarkably similar to that offered as justification for
subjecting autistic children to ABA intervention. Dawson (2008) reminds us that one of the
stated purposes of the UCLA FBP was “to ‘cure’ or ‘prevent’ homosexuality,” and that “[i]ts
unprecendented success in treating what was considered to be an intractable pathology was
reported by NIH-funded UCLA researchers in peer-reviewed journals (Rekers & Lovaas, 1974;
Rekers et al., 1974)” (n.p.). Indeed, Dawson opens her discussion with the closing statement of
the Rekers et al. (1977) publication: “Gender disturbed children desperately need treatment”
(quoted in Dawson, 2008, n.p.). Additionally, according to Dawson (2008):

The UCLA researchers repeatedly wrote that the young boys targeted by their early intensive ABA-based treatment
suffered terribly and were in pain. At all possible levels (physical, emotional, economic, social, etc.), their prognosis was
described as “extremely poor” with a high risk of criminal, antisocial, and self-destructive behaviour. Their future was
one of “numerous crippling difficulties” and “pain, misery, and despair” (all quotes from Rekers et al., 1977). (n.p.)

In addition to the rhetorical fearmongering about a poor prognosis and generally scary future if
such children weren’t provided with ABA intervention, there is the additional rhetorical
similarity of the foregrounding of the parents’ concerns and fears (which were fueled at least in
part by homophobic and ableist fears, respectively). According to Dawson (2008), it was the
“parents of these reportedly severely disordered children” whose “needs, values and goals were
considered paramount” (n.p.). There was,

according to the UCLA researchers . . . a “moral and ethical obligation” to intervene and provide a treatment which had
been demonstrated to be effective. The fundamental purpose of this behavior analytic treatment was, they wrote, to help
children whose present and future is so filled with hardship that it would be clearly unethical not to render them
professional help (Rekers et al., 1977). (Dawson, 2008, n.p., emphasis in original)

Thus, we see in the contemporaneous justifications for ABA intervention with “feminine boys”
the same set of rhetorical devices deployed in the past several decades’ justifications of ABA
intervention for autistic children, including: (a) general fearmongering and trafficking in claims
that to be LGBTQ is inherently bad (e.g., necessarily resulting in “pain, misery, and despair”—
just as to be autistic is framed as essentially tragic, catastrophic, and hopeless); (b) a
foregrounding of the needs, values and goals of the parents of so-called feminine boys over those
of the boys themselves (just as the needs, values and goals of the parents of autistic children are
foregrounded over those of the autistic children in question); and (c) a deployment of both
“scientific” and “ethical” discourses to justify the commonsense naturalness of the decision to
employ ABA intervention. That is, in both cases, “gender disturbed” and autistic children are
cast as desperately in need of treatment, and given the demonstrated scientific efficacy of the
ABA intervention available, it would be unethical not to provide it.
And this is precisely why both “science” and “ethics” are wholly inadequate as discourses for
resisting ABA (or any other commercialized intervention) as an intervention practice for autistic
people—this is hardly an ideological issue anymore. Rhetoric is used not merely to persuade
others of the truth or value of one’s ideological position; rhetoric is used as a tool for exercising
and consolidating political and economic power. Understanding the questions and issues of ABA
intervention as they relate to these two groups of young people targeted for ABA intervention
over the last 75 years requires recognizing that science, as a discourse, is deployed rhetorically.
Ethics is likewise deployed rhetorically. Both are discourses deployed in accruing and
consolidating power. Trafficking in deficit-driven narratives of apocalyptic futures for people’s
children (disregarding the perspectives of the children themselves) is the deployment of a
rhetorical tactic. In many ways, the basic ideological and rhetorical architecture for ABA
intervention for LGBTQ people didn’t look all that different in the late 1970s from the
ideological and rhetorical architecture for ABA intervention for autistic people did in the late
1980s and early 1990s. But clearly, the trajectories of these very similar ideological, rhetorical,
and methodological trends radically diverged. What was different? What changed?
As Pyne (2020) incisively points out in his analysis of Canadian policy, “the process of trans
communities wresting themselves out from under conversion therapy involved discursively
shifting from having a condition to being human,” ironically describing this in Lovaas’s
language as a “‘process of building a person,’” a process Pyne notes is “still incomplete for
autistic people” (p. 341). However, I will argue that the distinction between these two divergent
trajectories for queer and for autistic people in relation to ABA—in Ontario, in the United States,
and elsewhere—cannot merely be attributed to discursive, intellectual, affective, or rhetorical
strategies. Rather, these discursive, intellectual, affective, rhetorical, ideological, and ultimately
ontological victories served not as ends in themselves, but rather as the means to consolidating
economic, commercial, policy, and legislative hegemony and institutionalization. These are the
materialities of the rhetorical foundations of the AIC: they buttress and enable the
commodification of autism and therefore of autistic people. It’s not just that queer and trans
communities managed to discursively shift from “having a condition” to “being a human,” it’s
that in so doing they managed to escape industrial-scale commodification.
Lastly, it must be noted that in late 2020, “following concerns raised regarding the ethics of
using reinforcement and punishment to reduce gender nonconforming behaviors” (SEAB, 2020a,
p. 1837), the editor-in-chief of the Journal of Applied Behavior Analysis (JABA), together with
the Society for the Experimental Analysis of Behavior (SEAB) and JABA’s publisher, Wiley
Periodicals, LLC, issued a joint Expression of Concern about JABA’s publication of Rekers and
Lovaas (1974) (SEAB, 2020a, 2020b). An Expression of Concern is not a retraction, and
although the joint authors concede that “by today’s standards and in light of our current scientific
knowledge, the study would be considered unethical,” (SEAB, 2020a, p. 1837), in the authors’
judgment the ethical concerns about the study did not rise to the level that would warrant
retraction.
It is further noteworthy that “a diverse group of Behavior Analysis Professionals” (Leland,
2020, n.p.) subsequently filed a petition at change.org calling upon JABA to fully retract both
Rekers and Lovaas (1974), as well as Rekers (1977):

The undersigned . . . assert that an Expression of Concern is not an act of due diligence, and call for the official retraction
of both Rekers & Lovaas (1974) Behavioral Treatment of Deviant Sex-Role Behaviors in a Male Child as well as Rekers
(1977) Atypical Gender Development and Psychosocial Adjustment, as they meet retraction guidelines (COPE, 2019) of
publishing unethical research. We were disheartened to see an Expression of Concern which shows more concern for the
reputation of the field of behavior analysis than for the harms caused by the publication addressed (Rekers & Lovaas,
1974) and the subsequent publication not addressed (Rekers, 1977). (n.p.)

Johnson (2021) further critiques the basis of JABA’s Expression of Concern, calling into question
both the authors’ assertion that “the available evidence does not make it clear that the original
study was unethical by the standards of that day” (SEAB, 2020a, 1837) as well as the authors’
decision to create that criterion to serve as the basis of their decision not to retract the
manuscript. It is indeed heartening to see ABA professionals themselves both raising significant
ethical concerns about the FBP, as well as rejecting the field’s apparent tendency to prioritize
risk (presumably reputational, legal, and possibly financial) to the field over the very real harms
caused by the work to young people and other clients of ABA services.
Of course the elephant in the room surrounding this retraction debate is the name of the
second author of the publication in question (Rekers & Lovaas, 1974). This publication, which
reported on the FBP, and the multiple publications reporting on the YAP, share not only a
designer and principal investigator and author (Lovaas) but also share design elements, including
the use of contingent aversive punishments on young children. While the ABA industry currently
brands itself as using “positive” approaches and distances itself from the use of aversive
punishments, it nevertheless continues to tout as its “gold standard” a treatment protocol
(Lovaas, 1987) that achieved its still-never-replicated “best outcomes” through the systematic
deployment of contingent aversive punishments against young autistic children. Fortunately (for
JABA), they didn’t publish Lovaas’s 1987 study (though they did publish other reports on the
YAP). It remains to be seen whether this debate within the field of ABA as to the ethics of some
of its foundational “scientific” work represents merely a minor political course correction, or a
significant cultural inflection point. We shall see if the industry maintains its allegiance to the
history and the legacy of Lovaas’s “screams, slaps, and love” (Moser & Grant, 1965) approach to
“treating” autistic children, or whether its “concerns” may one day extend to the use of
reinforcement and punishment to reduce nonconforming autistic behaviors as well.

You Might Be Losing the Culture War If ...

By the turn of the century, the molten ideological and rhetorical architecture of the AIC had
begun to forge within its fires a gargantuan economic apparatus—the policy, bureaucratic,
legislative, and commercial landscape necessary to sell, buy, and thereby profit from the
intervention industry for autistic children. That is to say: both autism and autistic people were
successfully commodified; the cultural logic of intervention was hegemonically consumed; and
the AIC had successfully groomed and cultivated markets for autism industries. The industrial
complex subsequently developed, institutionalized, scaled up, and even globalized. Fortunately,
no such economic apparatus of comparable scale has yet emerged from within the ideological
and rhetorical groundwork laid advocating for ABA intervention for LGBTQ youth. This is not
just losing the culture war. This is being successfully turned into a commodity for the harvesting.
You might be losing the culture war if you are understood fundamentally to be a condition,
rather than a person. You might be losing the culture war if the general public believes that
existing people like you should be changed, and that future people like you should be prevented
from existing in the first place. You might be losing the culture war if you are presented to your
society by your government as constituting a significant public health risk to others, rather than
as a person who experiences significant risks to your own health as a consequence of bigoted
attitudes, culture, and public policy. You might be losing the culture war if the dominant voice in
public policy and advocacy and popular culture about your experience is that of people who are
not you, who might be a parent to someone like you, who want no one else like them ever to
have to experience parenting a person like you. You might be losing the culture war if fear is
driving public policy rather than reason (or hope), and if the rhetoric of science has been
successfully and scientistically deployed to brand political and ideological positions as
legitimate, neutral, and commonsense. And most importantly (and most ominously), you might
be losing the culture war if you are more valuable to your society (and its economy) as a
commodity than as a constituency.
The politics of hope, of truth, and of fear converged in the last decade of the 20th century and
the first decade of the 21st to create a perfect rhetorical storm that stoked the media climate of a
hot autism culture war. And this context—the rhetorical, ideological, epistemological, and
ontological foundational architecture of the AIC—successfully manufactured the markets,
consumers, and consumer confidence in the AIC, which successfully kindled the fires in which
the economic apparatus of the AIC was subsequently forged.

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PART THREE

The Economic Apparatus of the AIC:

Incorporation, Legislation, and Capital Investment
(1998–present)

P ART THREE EXAMINES THE building of the economic apparatus of the AIC: the structures,
institutions, policies, commercial activities, and industries that sprang up to harvest profit
from the commodification of autism and autistic people and the markets for those commodities
carefully cultivated by the cultural logics of both intervention and prevention. This ideological
and rhetorical architecture of the AIC functions to create, animate, and sustain at least two
predominant markets for profit generation: one, near-term; the other, somewhat longer-term. The
near-term market is the intervention market, and it is this market that behaviorism happened to
animate and so effectively to capitalize upon. This near-term market comprises multiple satellite
and subsidiary markets as well (e.g., the diagnostic market, the litigation market, the
pharmaceutical market, and sundry general kitsch markets, etc.), but each of these is
fundamentally linked to the foundational existence of the intervention market. Myriad competing
interventions (e.g., Developmental Models of Autism Intervention [DMAI], TEACCH, and
others) actively participate in the autism intervention marketplace; however, I continue to focus
in this analysis upon ABA intervention in particular, as the ABA industry provided both the
foundational ideology and the foundational technology for the widespread scaling up and
economic and policy institutionalization of the intervention industry itself (within which other
intervention approaches compete for market share, albeit on far from competitive terms). The
longer-term market is the prevention market, and this market is more speculative and futures-
oriented, relies more heavily upon the continuing commodification of autism as a menacing,
threatening, ontological category (rather than upon autistic bodies), and relies heavily upon
capital investment in basic genetic and genomic research. Indeed, this latter market may
ultimately not require the existence of the commodity of autistic bodies at all, but instead may
organize its commercial activities around the hoped-for and promised future absence of autistic
bodies.
Chapter Seven specifically examines the intervention industry of the AIC, including the roles
played by the nonprofit corporations BACB® and Autism Speaks in grooming the commercial
landscape for the eventual booming of the profit-generating autism intervention industry. Once
the nonprofit corporations have done their work, the for-profit enterprises set up shop, and I
explore the rapid influx of venture capital fueling the current boom in the underregulated (and
highly profitable) ABA intervention industry. Chapter Eight specifically explores the prevention
industry of the AIC, including the gargantuan economic investments (much of that, investment
of public dollars) in basic genetic and genomic research, further venture capital investments, and
the perennial investments in (re)branding and public relations as necessary business activities
within the autism industries generally. Both the intervention and the prevention industries
demonstrate the nimble diversification of the autism industries within capitalism, and the
increasing orientation of the industrial complex toward futurity in indefinitely extracting profit
from the commodities of both autism and autistic people.
CHAPTER SEVEN

Intervention, Inc.:
Nonprofit Corporations and Venture Capital

I DEOLOGIES BOTH ANIMATE AND manufacture markets. Recall Friedman’s doctrines—sometimes

markets must be created, often with the facilitation of the levers and tools of governments, in
order to maximally profit within neoliberalism. But consider also that markets, once established,
both animate and perpetuate ideologies. That is, once markets take off and become reliable and
lucrative generators of profit, they seem also to be somewhat self-sustaining, irrespective of any
initially animating ideology or even empirical circumstances. This was the crux of Eisenhower’s
warning about the military industrial complex: before the profit-generating architecture became
entrenched, there had once been vibrant public debate over the proper role and size of the
national military and how much investment of the public purse was warranted and justifiable in
the militarized pursuit of national security aims. But once the military industry became a reliable
and lucrative generator of profit for corporations and private industry, once those industries
became powerful policy lobbies in themselves, once those industries employed a workforce in
substantial enough numbers to animate voting blocs and the plutocratic donor class within
congressional districts and states, there was perhaps somewhat less discussion about the
necessity of this industry for national security, and somewhat greater justification of the
necessity to continue feeding that economic engine solely for the sake of maintaining its role as a
profit-generating sector of the economy. Thence, an established market eventually perpetuates
and props up its founding ideology, in an Escher-esque sort of way.
As previously illustrated, the autism intervention industry is fundamentally built upon the
commodification of autistic bodies as its primary raw material for the harvesting, and while a
range of competing interventions certainly participate in selling their services in that existing
marketplace, none of them can reasonably be said to have created the underlying ideological or
economic architecture of the AIC that undergirds the autism intervention industry—the ABA
industry must be given the credit (or blame) for that. The production of this emergent economic
and commercial architecture relies upon the involvement of nonprofit corporations, legislative
and policy processes, and capital investment. Specifically, I explore in this chapter the
interrelated and overlapping involvement of the remaining two networks of foundational
plutocrats of the AIC—the Behavior Analyst Certification Board® (BACB®) and Autism Speaks
—in bringing about, building upon, and scaling up the economic architecture of the AIC. These
two networks are central pillars of the intervention industry of the AIC, though both, perhaps
ironically, are actually nonprofit entities.
First, I analyze the ways that the activities of these nonprofit corporations have been and
continue to be foundational to the extraction of profit from autistic bodies in the intervention
market of the AIC. The early decades of the AIC worked to successfully commodify autism and
autistic people and to distribute for widespread consumption the cultural logics of both
intervention and later prevention. From the turn of the century on, the AIC’s main priority has
been to deploy those logics in order to more successfully capitalize on those commodities, and I
analyze the labor of these two nonprofits as having been (and continuing to be) central to
facilitating each of those aims. Lastly, following the creation and softening up of the marketplace
by the work of these nonprofits, I analyze the subsequent “boom” of the for-profit intervention
market, created by the eventual influx and large-scale investment of venture capital into that
newly-created, highly lucrative, and relatively unregulated marketplace.

Intervention, Inc.: The Behavior Analyst Certification Board (BACB)

The first of these pivotal autism nonprofits to incorporate was the BACB, which was
incorporated in the state of Florida as a non-profit corporation in 1998, enjoying 501(c)(3) tax-
exempt status with the U.S. Internal Revenue Service (IRS). As briefly described in Chapter
One, The BACB’s primary raison d’etre is as a credentialing organization for the subfield of
ABA practitioners; it facilitates and oversees the certification of multiple levels of behavior
analysts (including Registered Behavior Technicians® [RBT®s], Board Certified Assistant
Behavior Analysts® [BCaBA®s], Board Certified Behavior Analysts® [BCBA®s], and Board
Certified Behavior Analysts-Doctoral® [BCBA-D®s], with baseline educational requirements of
a high school diploma, bachelors degree, masters degree, and doctoral degree, respectively).
According to the BACB,

The BACB was established in 1998 to meet the credentialing needs of ABA practitioners, governments, and consumers of
ABA services. In the BACB’s early years, its certification programs grew consistently but slowly. In its first 13 years, the
BACB certified 10,000 individuals. In the last seven years, this number has grown to more than 100,000 certificants! In
addition, since 2009, 31 states have passed laws to license behavior analysts. (BACB, n.d.b)

The BACB was incorporated in 1998, and in 1999 they reported having produced 28 BCBA
certificants and two BCaBA certificants. Each year since its establishment the BACB has logged
a nearly exponential rise in its number of certificants, and at the close of 2020 (just 22 years after
its incorporation), the BACB had certified a cumulative total of 44,025 BCBA certificants and
4729 BCaBA certificants (BACB, n.d.a). Since the incorporation of the BACB (in large part
because of it), the field of ABA has undergone rapid growth in its number of practitioners as
measured by the number of people obtaining BACB certification—indeed, the number of
certified ABA practitioners has more than tripled in the past decade (Johnston et al., 2017).
It is worth pointing out that the BACB substantially expanded their practitioner base and
reached their exclamatory achievement of “more than 100,000 certificants!” largely by creating,
in 2014, the Registered Behavior Technician (RBT) certification, a paraprofessional certification
with minimal educational requirements of a high school diploma or equivalent (as opposed to
BCBA, which requires a graduate degree, or BCaBA, which requires a baccalaureate degree,
neither of which need be content-specific degrees). Creating a paraprofessional level of
certification would seem to have been a sound decision for the industry, because in 2014, its first
year of offering the RBT certificate, the BACB certified 328 RBTs, whereas by the end of 2020
the BACB has reported a cumulative total of 89,122 RBT certificants, whose recipients comprise
by far the largest subgroup of any single certification offered by the BACB (BACB, n.d.a).
Nevertheless, all of these multiple levels of certificants pay hundreds of dollars in application
fees, examination fees (to Pearson), renewal fees (in perpetuity, every 2 years), and various
sundry other administrative fees to BACB. While the certifying body (BACB) may be a
nonprofit corporation, the many private consultancy firms and LLCs that this industry has
spawned are not, and thus the establishment of this nationwide (and globalizing) certification
mechanism facilitated a significant escalation in the proliferation and growth of the ABA
intervention industry in the first two decades of the BACB’s existence.
The BACB is quick to point out on its own website that it is not a professional membership
organization for the field of ABA; rather,

the BACB’s job is to credential practitioners of behavior analysis and to coordinate with regulatory authorities. Although
we are sometimes called upon to engage in advocacy and political and social commentary, our involvement in these
activities is necessarily restricted by some of the entities mentioned earlier [e.g., IRS regulations]. In our regulatory–like
role, the BACB is prohibited from engaging in political activity and has very strict limitations on its acceptable activities.
(BACB, n.d.b, bracketed text inserted)

Thus, due to regulatory restrictions imposed upon the BACB by virtue of its incorporation as a
tax-exempt nonprofit corporation, it is legally prohibited from engaging in explicit advocacy,
lobbying, or other political activity or social commentary, such as may be expected of a
professional membership organization. As the BACB succinctly puts it, “The BACB doesn’t
have members; we have certificants” (BACB, n.d.b). That said, the BACB does actively
encourage its certificants to join and become involved with ABA’s major professional
membership organizations, particularly the Association of Professional Behavior Analysts
(APBA) and the Association for Behavior Analysis International (ABAI) (remember those
acronyms; we will return to them later). As the BACB explains to their certificants, “These
organizations were established to provide different services than a certification board and are
permitted much more flexibility in their permissible activities, including making public
statements and taking a stand on social issues” (BACB, n.d.b).
Here, I’ll briefly discuss two not unrelated evolutions in the clinical practice of ABA and
efforts to establish it as a profession, the ways that the BACB has been involved in those
developments in its capacity as a credentialing organization, and the ways that each of those
developments is also tied to the intervention industrial complex itself. The first of these
developments is the evolving trend toward state-level licensure of ABA practitioners (rather than
merely BACB-issued certification), and the second is the related institution by the BACB of
professional codes of ethics. But first—a very brief, partial, and truncated history of the BACB:

A Brief History of the BACB

As noted, the BACB was incorporated in 1998 as a nonprofit corporation in the state of Florida,
with the explicit purpose of creating a centralized body regulating the professional certification
of ABA practitioners. This was not the first initiative by the field of ABA to attempt to regulate
its own practitioners, as more mature professions do (previous efforts date back as far as the
1970s); however, it appears to be the one that stuck. (For a detailed narrative of this particular
history, albeit penned by employees of the BACB itself, please see Johnston et al., 2017.)
According to Johnston et al. (2017),
Early on, behavior analysts were interested in certification processes that would protect both consumers and the
profession. The primary concerns expressed at the time dealt with poorly trained individuals who would harm both
consumers and the profession’s reputation through their incompetence. (p. 524)

These concerns followed on the heels of several highly publicized incidents of practitioners
engaged in clearly abusive and indefensible behavior toward institutionalized disabled people in
the name of “modifying” their behavior. The fear among top behavior analysts at the time was
that “the treatment approach had been oversold in ways that suggested that anyone could
implement treatment” (Johnston et al., 2017, p. 525), and there was clear concern that not only
must the field of ABA and its practitioners better protect “consumers” (i.e., potential victims of
poor and abusive ABA practice), but also that they must better protect the reputational currency
of the field of practice of ABA itself from being branded in an unflattering light.
Thus, from the beginning, efforts within the field to both establish professional standards of
certification (and later licensure), as well as efforts to establish professional codes of ethics, were
integrally intertwined, and both efforts, to a certain extent, were undertaken with concerns for the
positive and sympathetic branding of the field of ABA (and its practitioners) in mind. Indeed the
argument could be made that the organizational title of the “Behavior Analyst Certification
Board” and its primary certification title of “Board Certified Behavior Analyst” were significant
branding achievements in and of themselves. In most other human service professions (e.g.,
education, social work, psychology, medicine, etc.), the moniker board certified denotes an
advanced level of professional certification above and beyond the basic licensure or certification
required to enter the field as a practitioner; in the case of ABA practitioners, it denotes merely
that basic, entry-level requirements have been met, although to potential consumers it may very
well (erroneously) connote that its holder has achieved an advanced level of professional
training, experience, competency, and recognition (Dorsey et al., 2009, p. 54). It is of course
possible that the professionals who incorporated the BACB as a nonprofit were unaware of this
common denotative usage of board certified in most other human service professions and that
the consequent connotation of BCBAs being advanced professional-level practitioners was
merely an unfortunate and unintended oversight; however, I am reluctant to underestimate the
marketing and branding savvy of the BACB’s founders, given the field’s decades-long history of
exquisite attentiveness to such matters.

BACB and State-Level Licensure Trends

Approximately a decade ago there was an ongoing internal debate among leading ABA
practitioners as to the relative benefits and drawbacks of the field moving toward state-level
licensure as opposed to maintaining the only recently established internal (BACB) certification
as the field’s primary mechanism of credentialing its practitioners; however, state-level licensing
of ABA practitioners commenced in 2009 and, at the time of this writing, 31 U.S. states require
ABA practitioners to obtain a license from the state in order to practice within it. The public-
facing conversation that took place among ABA practitioners as to the merits and demerits of
state licensure as opposed to BACB-issued certification is instructive in understanding the role of
the nonprofit in building the economic architecture of the AIC, including the targeting of sources
of revenue and the legislative, regulatory, and bureaucratic streamlining of that revenue to flow
easily and efficiently into the coffers of independent ABA consultancies.
In Behavior Analytic Practice, the practitioner journal of the ABAI (the field’s international
professional membership organization), Dorsey et al. (2009) published a piece titled “The Case
for Licensure of Applied Behavior Analysts,” in which they argued:
As applied behavior analysts, we are facing a very difficult time in the development of our profession. Licensure will
benefit the consumers of our services by improving their ability to choose between appropriately trained professionals and
those who are not. Having a formal licensing system will hold those who practice ABA to enforceable ethical standards
and give individual state boards of registration the discretion to establish educational standards commensurate with other
 human service professions. (p. 57)

The first and foremost argument offered by these authors in favor of licensure was that it would
“benefit” “consumers” of behavior analytic services. Indeed the first sentence of the abstract of
this manuscript invokes “the need to ensure that the consumers of these services are adequately
protected” (p. 53). Thus, dual primary responsibilities of this field (as with all human service
professions) are to both benefit the individuals being served and also to protect them
(presumably from harm).
However, an additional quandary posed by the sudden growth in the field of ABA practice is
also presented:
One potential downside of the increased recognition of the practice of ABA is an influx of individuals seeking to prosper
from this opportunity who may have little or no training or experience in ABA—placing both the consumers of their
services and the field at large at risk. (Dorsey et al., 2009, p. 53)

Thus, after initially centering the well-being of consumers of ABA services, the manuscript in
rather short order places an additional concern on the table that materially informs the licensure
debate: the potential risks posed not only to consumers (presumably risks of harm), but also to
the “field at large” of an “influx” of individuals seeking to “prosper” (such a polite euphemism
for “profit”) from the opportunity created by the recent boom in the ABA market. The question
at hand in terms of regulating ABA practitioners (certification or licensure?) is one that has
clearly been informed from the beginning with an eye to consideration of the ramifications for
ABA as an industry, rather than ABA as a profession, although of course industry and commerce
considerations are at the heart of most professional credentialing and licensing processes (e.g.,
medicine, law, psychology, etc.). Indeed, Dorsey et al. (2009) point out that
The tradition in medicine and other human service professions is that independently licensed professionals are those who
are sanctioned by their respective state boards of professional licensure to advertise their services to the public for a fee,
and when applicable, bill third-party insurance carriers for their services. (p. 54)

In addition to these arguments in favor of licensure for ABA practitioners (protecting clients
from harm, protecting the field and its practitioners from reputational harm and adverse legal
exposure, and facilitating a practitioner’s ability to bill third parties [school districts, insurance
providers, etc.] for their services), there were also devil’s advocates within the field articulating
counterarguments against licensure on the basis of those very same considerations. A prominent
early voice cautioning against licensure was Gina Green (Green & Johnston, 2009). Recall that
Green figured prominently in Chapter Five as a coauthor, with Catherine Maurice, of the parent
Manual for accessing ABA intervention and an enthusiastic and leading adopter of scientistic
rhetoric to bolster the legitimacy of ABA intervention during the 1990s, including the
cofounding of the Association for Science in Autism Treatment (ASAT). Green and Johnston
concede that licensure could in fact secure desired benefits for both clients and practitioners;
however, they argue that “pursuing licensure prematurely carries substantial risks for the entire
field” (p. 59), and that it is “important to consider the ramifications of licensure for practitioners
of applied behavior analysis (ABA), consumers of ABA services, and the field of behavior
analysis as a whole” (p. 59). The authors then proceed to consider the ramifications of licensure
for practitioners of ABA and the field of ABA as a whole (but curiously, not for consumers of
ABA services). Ultimately, while the manuscript begins with cursory lip service touting the
import of exploring the ramifications (presumably, both risks and benefits) of licensure to ABA
consumers, those ramifications are ultimately not addressed at all by the authors, and the crux of
the authors’ position seems unquestionably to be considering the ramifications (benefits and
risks) of licensure to ABA practitioners—of being in the business of ABA.
Green and Johnston (2009) begin by discussing what risks (to ABA practitioners and the
broader field in general) are not necessarily mitigated by licensure. That is, they point out that
two often-cited arguments in favor of licensure are that licensed individuals will enjoy a legally
protected right to practice and that licensure is often seen as a means of facilitating access to
third-party funding. While it may do both of those things, the authors argue that licensure is not
always necessary to achieve either of those aims or reduce their associated risks (and that
certification by a body such as the BACB may serve those purposes just as well and carry fewer
potential difficulties for and risks to the field’s practitioners). Green and Johnston discuss how
licensure initiatives carry their own risks to the profession, and can conceivably “backfire”:

Presently, although existing psychology licensure statutes in many states define the practice of psychology as including
behavior analysis, that inclusion is not always enforced. An effort to establish licensure for behavior analysts may
provoke stricter enforcement, or a mandate that behavior analysts work under the supervision of licensed psychologists.
(p. 62)

It seems worth noting that at the time this concern was articulated, early evidence indicated that
the fear of a “mandate” to “work under the supervision of licensed psychologists” was perhaps
overstated. Two states had recently passed licensure legislation in the year preceding Green and
Johnston’s publication, and Dorsey et al. (2009) point out that, “in both states, those licensed as
applied behavior analysts (‘behavior specialists’ in Pennsylvania) may practice independently
and are not required to be supervised by a licensed psychologist or other licensed professional”
(p. 57).
Nevertheless, it is of course accurate to say that pursuing licensing initiatives will
subsequently increase the scrutiny and oversight of a field of practice by involving governmental
boards and, often, statutory regulations; these authors point out that while it may of course be
desirable to mitigate the reputational risks to the profession of completely unregulated practice,
one should be careful what one wishes for, as we don’t want to actually tie our own hands in
terms of setting up a private practice. Thus, while consumer protection is certainly the primary
public-facing narrative (whether in arguing for or against licensing initiatives), it is clear that the
protection of the field of practice, its practitioners, and the broader industry and its markets are of
at least commensurate import, if not actually the driving concerns of the ABA industry’s efforts,
as led by its professional membership organizations and its certifying body, the BACB.
Green and Johnston’s guidance to their field and its practitioners is savvy, pragmatic, and
displays an exquisite sensitivity to both what legislation, policy, and regulation are more or less
for within neoliberalism (to facilitate and streamline business and industry), as well as how
legislative and policy processes work within neoliberalism (through professional [well-paid]
lobbying, organized constituent pressure upon elected officials, and ultimately, cultural narrative
—all effectively deployed as levers of political power). These authors’ targeted advice for
operating as effective players in the neoliberal landscape includes the necessity of (a) employing
top-tier professional lobbyists to pursue the agenda of one’s industry, (b) providing draft
boilerplate legislation to one’s legislators, and (c) grooming friendly legislative sponsors through
providing them with personal, narrative connections as to why this legislation would benefit their
constituents, or better yet, someone in their own family or community.
Green and Johnston (2009) are clear-eyed about the “bags of money” (p. 61) that successful
lobbying efforts will require and strongly recommend working with “a select network of
lobbying firms with an office in each U.S. state capitol and in Washington, DC,” (p. 60), in part
so as to coordinate licensing efforts among states and thereby ensure greater ease of mobility for
ABA practitioners, but also presumably because smaller, regional lobbying firms simply don’t
represent the top-tier of political power that firms with footprints in all 50 states and in the
federal arena can deliver. And they correctly point out that one needs not merely a substantial
bag of money to pay one’s own lobbying firm, which will “require continual feeding,” (p. 61),
but also the “second bag of money,” which must be

in the form of checks made out to legislators’ campaign organizations. Most legislators will greet constituents or lobbying
groups with larger smiles if they know they have supported their election efforts. It should be noted that state and
provincial behavior analysis associations may be legally constrained from making financial contributions to political
campaigns, so contributions may need to come from association members, in the form of either personal contributions to
politicians or contributions to the association’s political action committee. (p. 61)

This is a key distinction, and it echoes the BACB’s earlier caution that it is not at liberty (due to
regulatory restrictions imposed upon it by virtue of its federal tax-exempt status) to engage in
political advocacy or lobbying of any sort, but that it strongly encourages its members to be
active participants in the field’s two main professional organizations, the ABAI and the APBA,
which are able to engage in such efforts. This also may help to explain why Gina Green is
employed not by the BACB, but rather by APBA (where she has been the organization’s chief
executive officer since 2010, having also previously served as a president of ABAI), as her
political, branding, and business skills may arguably make a more significant impact upon her
field through her leadership of its professional organizations. None of these active lobbying
efforts were explicitly directed by or coordinated through the BACB; however, their role as a
politically neutral certification body that nevertheless strongly encourages its certificants to
actively participate in the efforts of the two primary professional membership organizations
likely has a substantial impact upon the direction of those efforts and the level of membership
support such efforts enjoy.
The authors additionally point to the benefit of providing friendly legislators (after making
campaign contributions to them, and securing a meeting or two) with draft statutory language:

In addition to a rationale for a licensure statute, it is important to offer legislators draft language for a proposed bill.
Legislators will not know exactly what behavior analysts want, and minor aspects of phraseology can have important
consequences. Legislators must be helped to understand why certain features are critical so that when they meet with
lobbyists representing other interests or negotiate with colleagues, the legislators can prevent any changes to the bill's
language that might create problems for behavior analysts and consumers of behavior analytic services. (p. 60)

Therefore, restrictions on explicit political lobbying efforts aside, the BACB does provide, for
the convenience of and as a courtesy to any interested lobbyists and/or legislators, a Model Act
for Licensing/Regulating Behavior Analysts (BACB, 2012) that just so happens to dovetail
seamlessly with the BACB’s existing standards for practitioner certification.
It seems likely that the BACB created and subsequently acted to advance this boilerplate
Model Act for Licensing following the earliest state-level licensure statutes that passed with no
requirement for feeding the certification industry so carefully established by the BACB. Dorsey
et al. (2009) note that “those licensed in these two states [Pennsylvania and Arizona] to practice
ABA are not required to maintain certification with the BACB or to pay any related renewal or
re-certification fees” (p. 57). It also seems likely that, due to the regulations overseeing the
BACB’s activities as a nonprofit corporation, including those prohibiting it from engaging in
explicitly political activities, the BACB’s Model Act for Licensing/Regulating Behavior
Analysts (BACB, 2012) was subsequently adopted by the APBA as its Model Behavior Analyst
Licensure Act (APBA, 2018). Both of these (nearly identical) iterations of boilerplate licensure
statutes require that licensees within a state be certified by BACB and maintain current
certification in order to maintain state-level licensure.
Additionally, the authors point out the potential increased likelihood of achieving one’s
legislative licensing agenda if one is successful in assisting a legislator to make a personal
connection with a constituent who is a consumer, rather than a practitioner, of ABA (or more
accurately, a family member of a consumer). Green and Johnston (2009) write that “one factor
that can help is having family members of consumers of behavior analysis services lobby
legislators and speak at hearings,” pointing out that “consumers often have credibility with
legislators that professionals cannot match” (p. 61). Indeed, they go so far as to say that “the
right consumer partners can help win the day for behavior analysts in the public policy arena,”
and that local behavior analysis professional organizations “can play essential roles by
developing alliances with consumers and mobilizing them to support legislative efforts” (p. 61).
They additionally point out that this tactic has been successful in related legislative lobbying
efforts, specifically those involving health insurance coverage for ABA intervention (to which
we will return shortly), noting that

If ABA practitioners are fortunate, they will identify legislators who have their own interests in public policies relating to
the practice of behavior analysis, such as family members in the profession or constituents who have won their
sympathies. Some legislators who have sponsored bills to require health insurance coverage of ABA treatment for autism,
for instance, have a child with autism in their family or know someone who does (e.g., O'Brien, 2008). (p. 60)

Thus, ABA practitioners such as Green and Johnston are strategic to recognize and deploy the
power of a cultural narrative in the service of their political agenda. This is the sort of tactic that
gets pieces of legislation branded as being protective of the interests of a particular, presumably
vulnerable or underserved constituency, even while the legislation is primarily being advocated
for by, and happens also to serve the commercial interests of, a particular intervention industry.
It is interesting to note that while this debate was circulating among ABA’s practitioners (and
it’s largely been settled—more than 30 states currently have ABA licensure laws and more are in
the legislative works), the discourse of “risk” figured prominently in both pro-licensure as well
as in anti-licensure (or at least, licensure-skeptical) arguments. However, the invocations of
“risk” discourse were fundamentally different depending upon the side of the argument. The pro-
licensure side of the debate primarily invoked concerns about the risk posed to clients and
consumers of unregulated and potentially unscrupulous providers causing harm to their clients.
Thus, within the articulation of the pro-licensure position, the invocation of risk drew more
explicitly upon ethics discourses (e.g., risk of harm). The side of the argument articulated by
Green and Johnston (2009), urging caution, deliberation, and ultimately pursuit of “alternatives”
to licensure also drew heavily upon the discourse of “risk;” however, in this case the
conceptualization of risk was more often either implicitly or explicitly consideration of the risks
not to consumers or clients but to practitioners and to the field at large. That is, the discourse of
“risk” invoked in tempering moves toward licensure involved considerations of reputational
and/or financial risk, wherein the organizing discourse/logic/epistemology/ontology is not ethics,
but rather, capitalism. This discourse appears to be less concerned with the legitimacy and ethical
standards necessary to establishing behavior analysis as a profession, and more concerned with
the policy and economic infrastructure necessary to establish ABA as a lucrative industry.
Consider the impact of the loosely coordinated efforts of the nonprofit BACB with the
affiliated professional organizations ABAI and APBA upon intervention markets and the ABA
industry. The application and certification processes generate revenue (if not profit) for BACB,
and the recertification and maintenance of certification currency process also generates revenue
(and profit) in perpetuity for partners such as Pearson, who collects testing and recertification
fees. With the move toward licensure now underway in a majority of U.S. states, there are
financial incentives for the states to keep licensure requirements fairly tightly aligned with
existing standards for BCBA certification so states do not have to bear the additional financial
and bureaucratic burden of licensing boards and other infrastructures within state governments.
Similarity of licensing across states increases the mobility of ABA practitioners, as well as
making the scaling up of regional or even nationwide corporate organization of private ABA
practices more efficient and cost-effective. The statutory licensing infrastructure advances the
process of further generating legitimation and credibility as capital that began with the infusion
of scientism in ABA discourse in the 1990s. Market opportunities are created at multiple levels
of the intervention infrastructure, and many practitioners, businesses, private and corporate
firms, and other entities are getting in on this newly created market that has thus far yielded
abundant harvests at nearly every level. This is a primary facet of neoliberalism at work: that the
various tools and levers of governments (e.g., statutory legislation, regulatory guidelines,
electoral politics, etc.) are deployed and leveraged in the service of industry and of capital.

BACB and Codes of Ethics

To reiterate, from the beginning, the BACB’s efforts to both institutionalize professional
standards of practice for certification (and later licensure), as well as efforts to establish
professional codes of ethics, were integrally intertwined, and both efforts, to a certain extent,
were undertaken with the intent to constitute and establish the field of clinical practice of
behavior analysis as a potentially successful commercial intervention industry. And from the
beginning, both of these intertwined efforts were undertaken with the twin stated aims or goals of
both protecting the recipients of ABA intervention from (physical, emotional) harm, as well as
protecting practitioners of ABA intervention and the broader field itself from (reputational,
financial, legal) harm. Rosenberg and Schwartz (2019) contend that the “field of behavior
analysis has experienced tremendous growth and change over the past 40 years,” and that “the
growth in the field has been fueled primarily by the use of applied behavior analysis (ABA) with
individuals with autism and by the concomitant health insurance funding for these services” (p.
473). Further, they note the correlation of this growth in the field with the increasing attention
paid to matters of ethics in behavior analytic practice, observing that this “explosive growth
brings a corresponding increase in concerns about the ethical behavior of behavior-analytic
practitioners” (p. 473).
In Chapter Five, I briefly discussed Wilkenfeld and McCarthy’s (2020) “Ethical Concerns
with Applied Behavior Analysis for Autism Spectrum ‘Disorder,’” published in the Kennedy
Institute of Ethics Journal. This manuscript offers an ethical analysis, written by academic
ethicists, considering whether the widespread and systematic use of ABA intervention on young
autistic children bears ethical scrutiny and meets the minimum maxim of most human service
professions to “do no harm.” The authors conclude, after a detailed and nuanced ethical analysis,
that
a dominant form of Applied Behavior Analysis (ABA), which is widely taken to be far-and-away the best “treatment” for
ASD, manifests systematic violations of the fundamental tenets of bioethics. Moreover, the supposed benefits of the
treatment not only fail to mitigate these violations, but often exacerbate them. (p. 31)
Further, and more specifically, they argue that “employing ABA violates the principles of justice
and nonmaleficence and, most critically, infringes on the autonomy of children and (when
pushed aggressively) of parents as well” (p. 31). However, I argue that the internal
discussion/dialogue/debate about ethics within the field of practice of ABA has been driven not
by the very real material risks and harms often experienced by autistic people subjected to ABA
interventions without their consent (e.g., young autistic children), nor even by academic or
theoretical or abstract considerations of the ethics of ABA as a field of practice. Rather, the
conversation has been constrained to the more pragmatic subset of considerations about how to
ethically conduct oneself as an individual ABA practitioner, presuming the field of practice itself
to be an ethical endeavor. Within the field of ABA as it has established and branded itself, it is
accepted as axiomatic that ABA practice is beneficial (having already successfully branded itself
as both “scientific” and “effective”); thus, one needn’t address the broader (and trickier) question
of whether the field of practice as presently undertaken and marketed is ethical.
And yet the rhetoric of ethics has always been integral to the licensure debate. Dorsey et al.
(2009), for example, pointed out that “having a formal licensing system will hold those who
practice ABA to enforceable ethical standards” (p. 57). While that is indeed a compelling
argument for licensure, it is unclear to what extent such ethical standards may be “enforceable.”
For example, many of the licensure laws as passed by state legislatures have a clause requiring
that, in addition to being 21 years of age and being certified by a state-approved certifying body
(typically, BACB), applicants for licensure “be of good moral character” (e.g., State of New
Jersey, 2018). How does one operationalize that? Who gets to decide? Presumably maintaining
current certification with a state-approved certifying body entails adherence to its Code of Ethics;
however, it is unclear if BACB’s own mechanisms for “enforcement” of this code of ethics will
be sufficient to keep up with the rapidly expanding scale and scope of the organization’s
certificants. Indeed, Dorsey et al. (2009) argued that “the BACB does not appear to have the
money, staff, time, or legal authority to provide the necessary ethical oversight” (p. 53).
As is the case with many standardized codes of ethics governing professional behavior—
whether one works for a government agency, a private corporation, or in this case, when
guidelines for ethical conduct come under the purview of an external professional certifying
body—the discourse reflected is not solely that of ethics. Indeed, discussions of ethics reflected
in both broader debates and ultimately in bureaucratic codes governing practitioner behavior is
not reflective of deep ethical considerations about whether or how the field (or subsets of its
practices) may potentially violate key ethical principles such as justice, nonmaleficence, or other
fundamental tenets of bioethics. Rather, they appear to be manifestations of an emerging
profession attempting to demonstrate its capacity for self-regulation of its licensed (or certified)
practitioners and to do so in a manner that, in addition to minimizing harm to its clients, places
equal attention on minimizing financial, legal, or reputational harm to the field of practice itself.
Thus, in absence of deep or critical engagement with ethical discourses, one must wonder if
the rhetoric of ethics serves, at least in part, a branding function. I have already discussed the
ways that ABA practitioners have drawn upon the concept of risk in discussing the pros and cons
of licensure, in some cases with apparent consideration of minimizing the risk (of harm) to
clients from ABA practice, and in others with apparent consideration of minimizing the (legal,
reputational, financial) risks to the licensing or certifying body, the employer of the practitioner,
and/or to the field of ABA practice itself. In this case, risk may be understood as what Rajan
(2006) calls one of those nicely “double-jointed words that always imply two things” (p. 41).
Rajan explores vocabulary and concepts (such as value) that neatly overlap the discourses of
both ethics and also of capital. Risk is similarly one of those words that does double duty
rhetorically—invoking considerations of ethics whilst simultaneously institutionalizing
considerations of capital. Within the organizing discourse/logic/grammar/epistemology/ontology
of neoliberal capitalism, codes of ethics are cast as a necessary component of doing business, as
much a mechanism for protecting the industry as protecting its consumers—or, as the case may
be, commodities.
By standardizing first certification and subsequently licensure, and then by establishing a
professional code of ethics for practicing behavior analysts, the nonprofit BACB has
accomplished a great deal in its first 20 years of existence. Apart from the obvious
accomplishment of producing the very labor force for the ABA intervention industry, the BACB
has also succeeded in rhetorically producing both legitimacy and benevolence for the field of
ABA intervention itself, both forms of reputational currency necessary to ensure and to scale up
revenue flows for the firms that employ the BACB’s certificants. And even though the BACB
incorporated a full 7 years before Autism Speaks existed, its first decade proceeded at rather a
more leisurely pace than its second, and it certainly seems to have learned and benefitted from
the more experienced neoliberal approach to being a nonprofit that was modeled for it by Autism
Speaks.

Intervention, Inc.: Autism Speaks

If the nonprofit corporation BACB has been hard at work behind the scenes for the past couple
of decades establishing both the professional and commercial legitimacy of ABA practitioners
and therefore of ABA as an industry, the nonprofit corporation Autism Speaks has been just as
hard at work (albeit in more visible and public-facing ways) for the last decade and a half, laying
and institutionalizing the broader rhetorical, policy, and legislative architecture of the AIC in
general, but ultimately in service of the interests of both the intervention and prevention
industries. Just as the BACB’s certificants are currently engaged in coordinated state-level
lobbying for passage of its model licensure act, so, too, did Autism Speaks play a central role in
coordinated (and successful) state-level lobbying for passage of its boilerplate legislation
constituting ABA as medically necessary (and therefore, required to be funded by health
insurance) treatment for autism. And although the BACB has existed for longer than Autism
Speaks (1998 versus 2005, respectively), it was Autism Speaks that took the lead and modeled
the corporate playbook for coordinated legislative lobbying that the BACB undoubtedly learned
from and in many ways, has successfully emulated.
Also categorized as a 501(c)(3) nonprofit charity by the U.S. IRS, and therefore prohibited
from legislative lobbying, Autism Speaks has operated with far less circumspection than the
BACB did in its early years. According to the IRS:

In general, no organization may qualify for section 501(c)(3) status if a substantial part of its activities is attempting to
influence legislation (commonly known as lobbying). A 501(c)(3) organization may engage in some lobbying, but too
much lobbying activity risks loss of tax-exempt status . . . . Organizations may, however, involve themselves in issues of
public policy without the activity being considered as lobbying. For example, organizations may conduct educational
meetings, prepare and distribute educational materials, or otherwise consider public policy issues in an educational
manner without jeopardizing their tax-exempt status. (IRS, n.d.) (emphasis in original)

I am no tax lawyer, but the term substantial seems to be doing a lot of rhetorical work in this
description. It is clear that Autism Speaks has routinely engaged in legislative lobbying for the
past 15 years, beginning with its support of the Combating Autism Act (CAA) in 2006, and
shortly thereafter with its coordination of nationwide state-level lobbying for health insurance
funding of ABA; however, since Autism Speaks undoubtedly has a cadre of highly qualified
corporate tax lawyers at its disposal, presumably care was taken to ensure that these efforts were
not “substantial” enough to risk its 501(c)(3) tax exempt status, or perhaps the organization was
simply “educating” lawmakers about why they needed to pass certain pieces of legislation.
I posited in an earlier publication (Broderick, 2011) that Autism Speaks had made two key
contributions to autism rhetoric (and therefore, politics) in its first 5 years of incorporation, the
first a rhetorical theme, and the latter a rhetorical tactic (and the latter of which was arguably the
more influential contribution). The first contribution was its ubiquitous rhetorical constitution of
autism as enemy through relentless metaphoric media representations of autism as disease,
epidemic, and abductor, as discussed in Chapter Six and elsewhere (Broderick & Ne’eman,
2008; Broderick, 2010). The second was its skillful, systematic, pervasive, and global
deployment of these and other rhetorical devices through its corporate-style, neoliberal, market
approach to not only cultural and political rhetoric, but also legislative and policy lobbying.
However, what my earlier analysis failed to do was to adequately analyze the relationship
between those two rhetorical contributions. That is, I earlier analyzed the tactics, but not the
strategy of these two central pillars of Autism Speaks’s activism in the early 2000s. In keeping
with Dolmage’s (2018) reminder that rhetorical analyses must be strategic—that is, they must
offer critical analyses of “the larger patterns and plans that orchestrate possibilities” (p. 2), I
analyze the larger patterns and plans deployed by Autism Speaks and subsequently successfully
emulated by BACB. Autism Speaks didn’t create this strategy—the larger patterns and plans that
orchestrate particular possibilities—they merely took a page from the broader neoliberal
playbook. My earlier rhetorical analysis was grounded primarily in cultural politics; the present
analysis, in political economy: industries hire lobbyists. And lobbyists deploy PR and media
initiatives to pursue their aims.
The overarching strategy connecting these two rhetorical contributions becomes obvious
when examined through the lens of the AIC—that is, when one understands the agenda and
activities of Autism Speaks not as those of an organization involved in autism advocacy and
science, but rather, as those of a powerful corporate-style lobbyist for the autism (both
intervention and prevention) industries. As discussed in Chapter Six, the first 5 years of Autism
Speaks produced ubiquitous and menacing PSAs, fundraising films, and media blitzes, all
apparently designed to groom media consumers to identify with and feel the fear of nonautistic
parents, to loosen their own wallets by contributing to fundraising initiatives, and to back (or at
least not block) Autism Speaks’s legislative agenda. For example, Autism Speaks produced in
2007 an “awareness” (or “propaganda,” depending upon your perspective) fundraising music
video, featuring the band Five for Fighting, titled “A World Where . . . ,” asking, “What kind of
world do you want?” and answering that rhetorical question with several stated aspirations,
including “a world where no family has to live with autism.” Just after the vocalist sings the
lyric, “Be careful what you wish for,” this music video ends (somehow, and ridiculously,
apparently, unironically) with the superimposed text, “Autism Speaks wants a world where
autism is a word in the history books” (Autism Speaks, 2007). Later, in 2008, the long-term goal
of eliminating autism was articulated even more pointedly by Autism Speaks cofounder Suzanne
Wright as her hope to “ultimately eradicate autism for the sake of future generations. If we
continue our current trajectory, we’ll get there in my lifetime” (Brown, n.d.). (Suzanne Wright
died in 2016, her goal of eradicating autism within her lifetime unachieved.)
Thus, a central explicitly espoused goal of Autism Speaks from its inception has been to
“cure,” “eradicate,” or otherwise eliminate autism in the future, creating a future world in which
autism is only “a word in the history books” (which of course envisions a future world with no
autistic people—be careful what you wish for . . . ). During those first 5 years, many autistic
activists and academics (myself included) were reactively responding to the dehumanizing,
fearmongering rhetoric of Autism Speaks, as if the organization were merely unimaginably
ignorant and needed to be better educated about the perspectives and agendas of autistic people.
But cultural fearmongering has been a tried and true tactic of fundraising and electoral politics
since time immemorial—why on earth wouldn’t it have been deployed in this case?
What autism’s early ontological history should have taught us is that autism is apparently
almost infinitely malleable. And within capitalism, this history should also have taught us that in
many ways, autism is what we need autism to be. Autism is as autism does. Autism Speaks, from
its inception, has been advancing the interests of the autism industries, and it has served a
uniquely outsized role in institutionalizing both the rhetorical/ideological as well as the
material/economic architecture of the AIC. Because of that unique role, bridging both rhetorical
and economic architecture, we can see the ways in which the former has always been deployed
in service of the latter, and therein lies the rhetorical strategy.
Arguably, Autism Speaks so aggressively produced media for widespread consumption that
constituted autism as a disease (an epidemic disease, no less) not because anyone necessarily
believed the repeatedly-asserted equations with cancer or diabetes (neither of which involve
epidemic spread, either), but rather, because they needed it to be ontologically cast as disease if
the second prong of their strategy were to be successful: lobbying for legislation that would
streamline the harvesting of health insurance funding as a steady stream of third-party funding
for ABA intervention. If health insurance funding were identified early on as a potential revenue
stream to subsidize access to ABA intervention, then it would be necessary to invest some time
and media saturation in the production (and consumption) of autism as disease in order to make
the subsequent argument that ABA intervention was “medically necessary,” and therefore,
logically, appropriately funded by health insurance dollars.
In 2007, after 2 years of media saturation casting autism as epidemic disease and 1 year after
the successful passage of the CAA, Autism Speaks turned its lobbying efforts to a longer-term
goal: that of securing and streamlining access to funding streams, to facilitate the flow of revenue
into the nascent autism intervention (ABA) industry. Recall Rosenberg and Schwartz’s (2019)
contention that ABA as a field of practice has experienced “tremendous growth” in recent
decades, “fueled primarily by the use of applied behavior analysis (ABA) with individuals with
autism and by the concomitant health insurance funding for these services” (p. 473). The
significance of the “concomitant health insurance funding for these services” is not to be
underestimated—it played a pivotal role in shoring up the foundations of the AIC and in
preparing the commercial landscape for the subsequent scaling up of the ABA intervention
industry by an order of magnitude. By 2019, Autism Speaks had successfully lobbied for and
seen passed state-level legislation in all 50 U.S. states requiring health insurance policies
(whether private or public) to cover ABA as a “medically necessary” treatment for autism. (And
forgive me, but to characterize that lobbying activity as anything short of substantial is to sell the
very talented folks at Autism Speaks quite short, in my opinion.)
Targeting one’s revenue streams is an important pillar of any business plan (or industry), and
if one can guarantee consistent future sources of revenue by legally mandating third-party payers
to provide that revenue and bureaucratically facilitating the ease of its transfer, so much the
better. This coordinated and significant legislative achievement (accomplished in less than 15
years’ time) was almost entirely the work of the lobbying arm of Autism Speaks, an initiative
originally known as Autism Votes, (currently rebranded as their Grassroots Advocacy Network,
no doubt because “advocacy” is permissible under IRS regulations, whereas legislative lobbying
is technically not). Autism Votes should be rightfully credited with two not insignificant
rhetorical accomplishments (in addition to their primary, and significant—though apparently not
“substantial”—legislative accomplishments): (a) the rhetorical construction of ABA as
“medically necessary” treatment or intervention for autism, and (b) the rhetorical construction of
this coordinated, targeted, heavily funded, corporate-style legislative lobbying initiative as the
work of a “grassroots advocacy network.”
In the fall of 2007, just two years after its founding, and on the heels of the successful
passage of the CAA in 2006, Autism Speaks launched its Autism Votes initiative. This initiative
was self-described as a “comprehensive grassroots advocacy program, coordinating activist
efforts in support of federal and state legislative initiatives,” one that “has played a critical role in
securing federal legislation to advance the government’s response to autism, and has successfully
advocated for insurance reform to cover behavioral treatments” (cited in Broderick, 2011, n.p.).
At the time, when one clicked on the icon for “advocacy” on Autism Speaks’s homepage (one of
the four pillars of the organization’s stated missions), one was directed to the homepage of its
Autism Votes initiative (www.autismvotes.org). This initiative was not, apparently, merely one
facet of the organization’s “advocacy” agenda; rather, in 2007, it appeared to comprise its
advocacy agenda in its entirety. Currently, the various Autism Votes links redirect users to its
rebranded Grassroots Advocacy Network (autismspeaks.org/advocacy), with multiple
policy/advocacy objectives identified.
According to Autism Speaks’s 2008 Annual Report, in the first year of the Autism Votes
lobbying initiative, “we were able to push bills in five different states through the legislatures to
become laws” (p. 14, cited in Broderick, 2011, n.p.). (Does “pushing bills through legislatures”
not sound like legislative lobbying to you? It does to me, but then I am not a tax lawyer . . . ).
The legislative measures in each of those states were of course very similar, each being based in
large part upon template legislation actually drafted, circulated, and (let’s be honest) lobbied for
by Autism Speaks. In August of 2019, Tennessee became the fiftieth state to successfully pass
such legislation, “requiring all individual, small and large group plans to cover medically
necessary care for autism, including applied behavior analysis (ABA)” (Autism Speaks, 2019). It
seems significant to note that many of these pieces of state legislation passed their respective
legislative bodies with unanimous approval across both major parties, something that is
becoming increasingly unheard of in the contemporary, highly partisan political climate in the
United States. Additionally, these pieces of legislation were heavily and understandably lobbied
against by the health insurance industry lobby, the political clout of which, if anyone had
heretofore been unaware, was amply and visibly demonstrated as the powerful and formidable
political lobbying force that it is during the health insurance reform process in the U.S. federal
government during 2009–2010. How does a “grassroots advocacy” initiative go up against the
powerful health insurance industry lobby in the legislative policy arena and win, over and over
and over again? The same way other astroturf (sorry, “grassroots”) political initiatives do—by
deploying high-powered economic and political capital.
A branch of the Autism Votes initiative was at the time called Autism Speaks Government
Relations, its offices located inside the beltway in Washington DC, on K Street, where most
lobbying firms’ offices are located. According to the Autism Votes website, “The Autism Speaks
Government Relations Department is ready to help you put together an effective autism
insurance reform initiative in your state” (cited in Broderick, 2011, n.p.). Autism Speaks
Government Relations offered the dedicated supports of “policy consultants,” “grassroots
engagers,” and “communications managers,” and among the services offered by those personnel
were: assistance in preparation of draft legislation, provision of talking points, preparation of
testimony for legislative hearings, creation and housing of a state website on the Autism Votes
site, and PR and media promotion support (cited in Broderick, 2011, n.p.).
The positioning of Autism Votes as a “grassroots” advocacy initiative was itself an effective
rhetorical and political strategy (and accomplishment). One might argue that relatively few
“grassroots” disability advocacy organizations have at least 15 executive officers earning annual
six-figure salaries or have annual mid-six-figure contracts with corporations providing services
in areas such as government relations, public relations, marketing, or project management (cited
in Broderick, 2011). Nevertheless, the rhetoric of presenting one’s agenda as a “grassroots” one
clearly continues to be politically advantageous.
On the Autism Votes website at the time, their “Chapter Advocacy Network” was described
as “a group of elite volunteers dedicated to expanding involvement in autism advocacy.”
Additionally the “Chapter Advocacy Chairs . . . direct and activate their local community to
advocate for state and federal Autism Speaks initiatives” (cited in Broderick, 2011, n.p.). It is left
for the reader to decide whether having a group of “elite volunteers” come in to “direct and
activate” local communities “to advocate for state and federal Autism Speaks initiatives” is
consistent with the commonsense rhetoric of a grassroots political effort, and additionally, to
ponder exactly how this is different from legislative lobbying. Regardless of this judgment,
however, given the material political and economic impact of this initiative in the few short years
since it was launched, it appears to have been a powerfully effective rhetorical strategy,
constituting a larger “pattern or plan” (Dolmage, 2018, p. 2) that very successfully orchestrated
distinct possibilities for the autism intervention industry.
None of the individual rhetorical tactics deployed by Autism Speaks—the rhetorical
constitution of autism as cultural enemy or oxymoronically as a genetic epidemic, of urgency
therefore necessitating decisive and immediate action, of the legitimacy of ABA intervention
through the deployment of the rhetoric of scientism and the neoliberal market discourse of cost
effectiveness, of behavioral treatments as somehow being medically necessary, or of Autism
Speaks’s agenda as somehow emergent from a populist grassroots advocacy movement—none of
these rhetorical tactics were original or new or, really, noteworthy on their own. The new,
significant, and game-changing contribution of Autism Speaks during this time was its complex,
comprehensive, systematic, multipronged rhetorical strategy that made incisive use of Madison
Avenue-style cultural rhetoric and beltway-style political lobbying to orchestrate very particular
possibilities. It was indeed a remarkable rhetorical coup to be able to establish such consistent
cultural buy-in for behavioral interventions as “medically necessary treatments” for any
phenomenon constituted as “disease,” let alone the purportedly genetic phenomenon further
constituted as “epidemic”: autism. These contradictions internal to the rhetoric present as
insignificant, because they are overridden by the power of the comprehensive, pervasive, and
nearly unilateral cultural narrative deployed through Autism Speaks’s corporate-style, strategic,
market approach to rhetoric. It has proven thus far to be remarkably effective and enduring.
This is the point at which (when I talk about this analysis, as I’ve been doing with anyone
who would listen for nearly 20 years now) most people look at me rather skeptically and say
something along the lines of, “Oh, Alicia, you’re just so cynical—I’m sure that most of these
efforts are simply fueled by well-intended people who just want to secure what’s best for their
children. Not everything is about capitalism . . . . ” (That is as may be—and yes, of course people
want what’s best for their kids. And yet, everything is also about capitalism . . . ). And if you are
one of the people who’ve said similar things to me over the years, perhaps you will do me the
favor of reading on before reiterating those remarks.
Within American neoliberal capitalism, there are very particular forms of labor that are
reserved for nonprofit corporations, but in many industries, those labors are nevertheless integral
to the prosperity of that industry’s for-profit corporations. In some ways, the labor of these two
nonprofit corporations (Autism Speaks and the BACB) can be likened to preparatory investments
that increase the likelihood that future investments will be profitable. Or if, like me, you are more
of a gardener than a capitalist, the labor of the nonprofits can be similarly likened to conditioning
the soil before you plant—if you enrich the soil with compost, make sure that the Ph level is
hospitable to the needs of the crop you’re about to plant, etc., you’ll probably be rewarded with a
more bountiful harvest or more floriferous blooms than if you’d just turned over some dirt,
dropped in some seeds, and crossed your fingers. The rhetorical and ideological infrastructure of
the AIC has been laid and propagated for decades (compost—check). Enter the nonprofits—
media production/consumption scaled up (check); technocratic infrastructures such as
certification, licensure, billing codes, etc., in place (check); boilerplate legislation lobbied for and
passed that both secures sources of revenue for the industry (check), as well as the ability of
practitioners to legitimately and easily harvest that revenue (check). The industrial complex is in
place. Enter, large-scale infusions of capital investment.

The Intervention Industry and Venture Capital

In November of 2018, Diane Morris, marketing manager for IDD (Intellectual and
Developmental Disability) and ABA at Relias Industries, wrote a blog post titled, “The ABA
Business Boom” in which she stated that “The applied behavior analysis (ABA) industry is
experiencing an influx of investment dollars thanks to changes in state laws and insurance
coverage” (Morris, 2018). Relias as a corporation is described as being in the “education
industry” (zoominfo, n.d.), though appears to be a multinational firm that utilizes data analytics
and digitally delivered professional development content to “deliver better clinical and financial
outcomes by reducing variation in care” for its “more than 10,000 healthcare organizations and
4.5 million caregivers” (Relias, n.d.a) that comprise its clientele. The “changes in state laws and
insurance coverage” referenced by Morris are the changes, lobbied for by Autism Speaks and
now in place in all 50 U.S. states, requiring both private health insurance and federally-funded
Medicaid to pay for ABA as a covered and reimbursable medical treatment for autism.
In addition to this legislative accomplishment, one of the additional mechanisms that has
served to grease the flows of revenue toward the ABA industry has been the recent institution of
permanent billing codes, referred to as Current Procedural Technology (CPT) codes, for ABA
intervention by the American Medical Association (AMA). According to Morris,

Insurance coverage for ABA is now so common that the American Medical Association recently announced that as of
January 1, 2019, the medical billing codes for ABA will go from temporary to permanent. That means the Association
recognizes ABA as a medically necessary treatment. (Morris, 2018, n.p.)

According to Autism Speaks (2018), “ABA codes were first approved in 2013 and fell under
Category III (temporary),” although shortly thereafter a working group at the AMA was formed
in order to address and revise the ABA CPT code set.
 Autism Speaks (2018) reports that “The CPT Steering Committee included Autism Speaks,
the Association for Behavior Analysis International, the Association of Professional Behavior
Analysts, and the Behavior Analyst Certification Board” (n.p.). As a result, they report, “The new
Category I status should lead to fewer denials of coverage based on reasons that ABA is
‘experimental’ or ‘not medical’ in nature ” (n.p., emphasis in original). Please note that the
AMA’s CPT Steering Committee included the two nonprofit corporations Autism Speaks and the
BACB, as well as the two central professional ABA membership organizations that the BACB
encourages its certificants to actively participate in and align themselves with: the ABAI and the
APBA. While participation on this steering committee could not technically be characterized as
lobbying or engaging in explicitly political or policy or legislative work, the result of this
steering committee’s work (to establish permanent, Category I CPT billing codes for ABA
intervention services) nevertheless served to further the financial interests of the ABA
intervention industry, by streamlining and facilitating ease of third-party billing for ABA
clinicians and direct intervention providers.
Morris characterized the “ABA Business Boom” as resulting from the years-long legislative
and regulatory legwork of these autism nonprofit corporations, stating that “The applied behavior
analysis (ABA) industry is experiencing an influx of investment dollars thanks to changes in
state laws and insurance coverage” (Morris, 2018). So what happens when you spend decades
building an ideological apparatus in support of an intervention industrial complex? What
happens after you’ve developed a cohesive cultural narrative; groomed widespread consent
based on perceptions of scientific legitimacy and efficacy; literally created an intervention
industry including training, certification, and licensure requirements for its practitioners;
successfully passed boilerplate state-level legislation nationwide requiring insurance (both public
and private) to fund this particular intervention; and gone to the additional trouble of greasing the
techno-bureaucratic wheels of that revenue source by streamlining medical billing processes for
said intervention? According to Morris (2018), “The increase in insurance coverage, along with
the nation’s high rate of autism diagnoses, means the number of families clamoring for ABA
services has hit new highs” (n.p.). Therefore:

As we all learned in Econ 101, high demand plus low supply equals a business opportunity. The need for more ABA
providers has caught the attention of private equity firms. The market for ABA is so hot right now, there is even an
Autism Investor Summit scheduled for 2019. (Morris, 2018, n.p.)

Morris correctly points out that an investment of private equity monies could potentially
dramatically expand the availability of ABA intervention services available to families for their
autistic children. As an illustrative example, she notes that “Indianapolis-based Hopebridge went
from 17 offices in two states to 30 offices in four states after receiving an influx of cash from a
private equity firm” (Morris, 2018, n.p.). She also correctly cautions:

However, rapid expansion and a focus on profits can put quality of care at risk. Some autism experts worry that ABA
providers fueled by private equity will revert to “old school” ABA and fail to use contemporary ABA approaches that
incorporate naturalistic teaching strategies and developmental principles like joint attention. (n.p.)

Morris’s articulated concern about quality control is of course a thinly veiled marketing pitch to
ABA firms—private equity may enable you to scale up significantly, but Relias and our data
analytics and continuing education modules can help to ensure that you do so without
compromising quality control—and therefore, reputational currency, and therefore revenue, and
ultimately, profit (so hey, be sure to contract with us for our analytic and content delivery
services as you scale up).
As was asserted in Chapter One, the AIC is abundantly (and apparently nearly infinitely)
generative. There is money to be made (and being made) at nearly every imaginable turn. Not
only can Relias help you to ensure that you’re scaling up with attention and fidelity to quality
control (thereby building your ABA firm’s reputation and therefore longer-term profit potential),
but Relias can also salvage a fair amount of revenue and profit from its own little slice of the
AIC/ABA pie. On its website, Relias offers “solutions for ABA and autism service providers”
(among many other targeted “healthcare” service industries), saying “Relias can provide
convenient, effective training for your Board Certified Behavior Analysts (BCBAs), Registered
Behavior Technicians (RBTs), and anyone else in your office who needs to understand how to
work with people with autism” (Relias, n.d.b). Relias offers RBT curriculum “crafted by experts”
and, by its own report, routinely sells this curriculum to a wide range of clients including
“agencies, schools, universities, and licensed professionals.” Relias’s platforms for delivery of
this curriculum include a digital learning management system and mobile app, among others, and
instructors appear to be noticeably absent from the equation (a decision that no doubt contributes
to the articulated aims of efficiency, fiscal discipline, and profitability). And although they are by
no stretch of the imagination a large company (when compared to their direct competitors, and
with fewer than 1,000 employees), Relias nevertheless appears to be doing well enough for itself:
When comparing its third quarter, 2019 revenue ($59.5 million) to its third quarter, 2020 revenue
($170.6 million—nearly tripling revenue in one year, and the second half of that year
overlapping the first six months of a global pandemic), it would seem that the general business
model is working well, and may even prove to be relatively resilient of if not impervious to
pandemic economic effects (zoominfo, n.d.).
Let’s return to a point made by Morris that bears further exploration: she asserted in 2018
that “The market for ABA is so hot right now, there is even an Autism Investor Summit
scheduled for 2019” (n.p.). Indeed, in February of 2020, the second annual Autism Investor
Summit (hereafter, the Summit) was held in Los Angeles, with a notation on the website saying,
“We look forward to seeing you in February, 2021” (Autism Investor Summit, 2020). The third
annual 2021 Summit was held virtually April 19–21, and the videos of many of those sessions
are available to view online for a modest ($35) fee (Autism Investor Summit, 2021).
Nevertheless, according to the website for the 2020 Summit, the “demand for services is
increasing exponentially resulting in intense investor interest in this sector,” and it continues:

Currently, the autism services and therapeutic market in the U.S. is conservatively estimated to be valued at $5–7 billion
dollars and growing. This includes programs that serve individuals with autism as well as drugs targeting behavioral
issues in autism. The supply constraint and the growing demand for services has created a very attractive market that is
growing rapidly. Revenues of ABA programs are estimated to generate $2B–7B annually. These estimates are considered
conservative and we believe the market is substantially larger, with a TAM (total addressable market) of up to $70 billion
. . . . The market continues to be highly fragmented with fewer [sic] than 20% of the industry owned by consolidators.
Demand continues to outweigh supply. (Autism Investor Summit, 2020)

The targeted participants for this summit are autism intervention (ABA) service providers and
potential capital investors, primarily private equity firms and other venture capitalists.
Participants are assured that this is a “curated event” and that all participants are vetted by the
organization (so, no need to worry about a researcher or journalist or other curious onlooker like
myself being permitted to attend and take notes), and also that the Summit aims to create a
“unique opportunity for autism service providers and investors to meet in a private setting to
discuss the autism services landscape, opportunities for investment and to attain valuable insights
on the outlook for financial investment in autism healthcare services” (Autism Investor Summit,
2020).
Make no mistake: This is not an event designed to curate, disseminate, or debate information
about most current issues, perspectives, approaches, or even treatments for autism (let alone to
posit a universe outside of the hegemonic cultural logic of intervention). The purpose of this
annual event is purely and solely to put relevant stakeholders in touch with one another to
explore and exploit opportunities (for both buyer and seller) for profit generation in the ABA
industry. Questions of what might be effective, reliable, or valid, let alone ethical, just, or desired
interventions are not on the agenda, and indeed would be entirely nonsensical in this particular
context. The only question on the table at the Summit is what would be most profitable, and how
to go about logistically orchestrating that profit extraction. And if you are enough of a naive
optimist to be thinking at this point, “Why aren’t the voices of autistic people represented?
Nothing about us without us!” (you sweet thing—I appreciate you), please recognize that that
very question makes as little sense in this context as asking why the chickens and the soybeans
aren’t consulted when similar summits are taking place connecting corporate agriculture with
small family-held farms up for sale (which is to say, absolutely no sense whatsoever).
Autistic people are clearly and unapologetically and almost unconsciously (and therefore
hegemonically) the commodities in this equation. And the increase in the supply of this
commodity is actually what fuels the increase in demand for ABA intervention services, the
resultant relative scarcity of which subsequently makes it all the more lucrative a sector to invest
in, as demand is projected to continue to “boom” for some time to come. Under the heading
“Why now?” (e.g., why invest or seek an acquisition now, and/or why seek a buyer or other
capital investor now) on the Summit website, is the statement, based on what were then-current
numbers from the CDC,

2.5% of the U.S. population has autism. These numbers will likely increase as individuals in underserved markets are
better identified and receive an accurate diagnosis. Because of these growth rates, access to funding and demand for
services is increasing exponentially resulting in intense investor interest in this sector. (Autism Investor Summit, 2020)

Or as Morris (2018) succinctly stated, “High demand plus low supply equals a business
opportunity.”
It should be pointed out that none of these profit extraction mechanisms are new—the ABA
industry did not invent the phenomenon of private equity investing in a “healthcare” service as a
lucrative market for the extraction of corporate and private profit. The playbook being deployed
has been perfected (within the United States) over the decades-long neoliberal salvaging (and
savaging) of the healthcare, education, and myriad other industries that might (in other
governments and economies and societies and times) be rightfully regarded as “public sector”
industries. Indeed, readers outside the United States would be forgiven (and envied, and
hopefully forewarned) for not entirely understanding exactly how we allowed this to happen.
How have we so willingly handed over power over our own healthcare, over our own children’s
education, over so many other vitally important (indeed existential) sectors of our society and
our economy to corporate plutocracy, facilitated and accelerated in large part by a neoliberal
state and a culturally anesthetized populace? In hindsight, it is telling to recognize the strategic
foresight involved in rhetorically constituting autism as a “disease” in the late 1990s and early
2000s: such rhetorical strategy enabled the ABA intervention industry to successfully recast
itself as a “medical” intervention in order to create the logical (and legislative) congruence of
funding that (private) industry through both private and public health insurance dollars. That
particular rhetorical flourish (autism as disease) has since somewhat fallen out of favor and is no
longer dominant, which hardly matters, as it has already very effectively served its rhetorical
purpose of bureaucratically justifying the constitution of ABA as a “medically necessary”
intervention for autism, which is unlikely to be undone anytime soon.
The Summit explicitly positions this salvaging opportunity as an expansion of similar efforts
in other sectors of healthcare (which potential investors know full well have proved to be
extremely profitable) when they pitch the “opportunity” for investors as such:

Investors are in a strong position to consolidate, expand, and create the kinds of economies of scale that are common in
other sectors of healthcare, and in other industries. The autism service market is a highly fragmented marketplace with
many opportunities for consolidation, favorable returns on investment and the elevation of regulation and oversight of
care. Because autism treatment is a fairly new field, the industry lacks regulation and oversight. While this is a challenge
when evaluating the quality of treatment centers, it’s also an opportunity to implement cutting-edge treatments and
technologies. (Autism Investor Summit, 2020)

Just as is the case in every other industry in a neoliberal capitalist economy, the current relative
lack of regulation and oversight is a circumstance highly enticing to potential investors, as the
specter of future regulation may ultimately curb some of the profit potential to be extracted from
the industry down the road, so best to invest now while the profit potential is at its height.
The 2020 Summit website presents four “important factors in the current autism provider
landscape,” which they identify as intervention, demand, providers, and market (Autism Investor
Summit, 2020). In reviewing these four “factors,” it is abundantly clear that the latter (the
explicitly economic ones) are nevertheless built upon the foundations of the AIC’s ideological
and rhetorical infrastructure. The “intervention” factor of the “autism provider” landscape is
presented to potential Summit attendees as such:

The predominant treatment for autism is based on the science and methodology of Applied Behavior Analysis (ABA).
ABA is one of the few areas that attracts bipartisan political support and as of May 2019, 49 states in the U.S. mandate
insurance coverage of autism services . . . . ABA is considered the gold standard of treatment for autism. The National
Research council recommends a minimum of 25 hours per week of student engagement.

Thus, as we have seen since ABA’s rebranding beginning in the late 1980s/early 1990s, ABA is
cast as scientific and the “gold standard” of treatment. These assertions are brief, definitive, and
authoritative. They are not presented as contested, nor do they require legitimation, illustration,
or defense. This is the successful advancement of a hegemonic conceptual framework such that
its truth is not questioned. These are the foundational ideological, rhetorical, and ontological
achievements of the 20th century labors of the AIC.
Upon this ideological foundation the economic mechanisms of profit generation are built.
Within the hegemonic cultural logic of the AIC, ABA is an industry, and as such, its purpose is
profit generation. The second identified “important factor” in the ABA intervention landscape is
demand, and it is presented to the provider/investor as such:

The ABA market is growing at twice the rate of other multi-site healthcare businesses. With greater awareness, we are
seeing the beginnings of a reduction in the social stigma of autism and a formal diagnosis of autism leading more families
to seek intervention and support. As funding for autism services and awareness of autism is expanding, more and more
families are seeking services nationwide. Most providers report waiting lists for assessment and diagnosis, as well as
intervention, leading to rapid growth in this industry. In addition, there are many communities where services are lacking
bringing multiple organic growth opportunities to existing providers. (Autism Investor Summit, 2020)

Thus, the ABA industry is presented as a market and a healthcare business, and expansion of
availability of funding is understood to be driving demand for the intervention and hence growth
among the businesses providing that intervention. Expansion to underserved markets is also
identified as an organic engine of potential further growth, and “awareness” initiatives aimed at
stigma reduction are understood to serve the additional (or possibly central?) function of further
driving families to seek intervention services (thereby increasing demand, hence fueling
subsequent industry growth). And the beginnings of a reduction in the social and cultural stigma
related to an autism diagnosis is not regarded as a positive development in and of itself (nor as
something to be celebrated for lessening discrimination, exclusion, or other forms of
marginalization that autistic people experience), but rather, is presented as a positive
development because of the apparent impact that lessening of stigma has on families’
propensities to be willing to seek diagnosis, intervention, and support—i.e., more families
seeking these things means more paying customers (or customers with health insurance whose
providers will pay claims) for the business you’re considering investing in.
The third important factor the Summit identifies as necessary for understanding the ABA
industry landscape is providers:

In recent years, significant investments in autism service providers have occurred resulting in the beginning of
consolidation of this market. This interest and investment trend is driving a new level of competition and increasing the
standards against which providers need to comply and perform. Despite this growth, however; [sic] less than 10% of the
autism industry is owned by consolidators providing much opportunity for continued investment in this market. As
consolidators continue to buy up the market, issues such as the integration of clinical methodologies, operational
processes and administrative functions bring new challenges, especially because the industry is relatively young and
unsophisticated from a business operational standpoint. (Autism Investor Summit, 2020)

Since the incorporation of the BACB in 1998, many entrepreneurial-spirited behaviorists have
credentialed up and hung out their small-business shingles, building their own consultancies
from within their geographically local market, consisting of both individual payers (families) and
school districts as primary sources of clients, with the source of many of those revenue payments
ultimately being either public education dollars or public or private health insurance claim
dollars. Within neoliberal capitalism, “consolidation” of the provider market is a logical
evolution, thereby creating further opportunities for profit extraction (for both the provider and
the investor and/or acquirer). Less than 10% of the “autism industry” is presently “owned by
consolidators”: what an opportunity to get in on the ground floor of a lucrative industry, poised
for future (both near- and longer-term) growth.
The final factor presented by the Summit as important to consider when exploring the
landscape of investment opportunities in the ABA/autism industry is market, presented as such to
Summit attendees:

The total annual costs for children with ASD (autism spectrum disorder) in the United States are estimated to be between
$11.5 billion and $60.9 billion—a significant economic burden. It is estimated that the current ABA service provider
market is about $7bn with a TAM (total addressable market) of between $50–70bn. The ABA therapy market is expected
to grow at a 25% CAGR over the next 3–5 years. The needs of the aging autism population are grossly under serviced
providing additional opportunities for investors and providers. Many autism treatment organizations, and some of the
largest competitors are located in California. This is due to the fact that funding for treatment programs has been in place
there for over 5 decades, prior to the insurance mandates that were later put into place. (Autism Investor Summit, 2020)

Thus we see the high “costs” of autism trotted out once more as presenting a “significant
economic burden” to the United States, even though those very same “costs” (from the
standpoint of service providers and investors), of course, are better described from the receiving
end as “revenue,” and therefore represent less a burden than the high potential for profit. And
autistic adults—beware. It seems that the industry may be rethinking its branding tactic of
focusing all of its attention and rhetoric on autistic children, now seeing autistic adults as an
underdeveloped and underexploited market to capitalize upon. And look out autistic women, and
autistic people of color, and autistic people who live in the global south, and every other
underexploited (sorry, “underserved”) market—you’re next on the salvaging list. So when
Autism Speaks suddenly starts casting its “philanthropic” attention upon you and offering the
diagnoses and interventions that are your “right,” prepare to resist the salvaging, as each of these
autistic communities now represents “additional opportunities for investors and providers.”
It is also noteworthy that some of the largest “competitors” are acknowledged to be in
California, precisely because mechanisms for streamlined funding have existed there for decades
(to say nothing of the earliest ABA programs marketing their intervention services there to their
local communities). Indeed, states such as California, New Jersey, and Massachusetts (among
other states) are often highlighted as having a disproportionately high prevalence of autism
within their respective states. However, as observed by Mazumdar et al. (2013) in their study of
geographic “clusters” of autism diagnoses, their findings “implicate a causal relationship
between neighborhood-level diagnostic resources and spatial patterns of autism incidence,” (p.
87), which is to say: where more autism diagnostic and intervention service centers exist (the two
offered services tend to go hand-in-hand from a business model perspective), children in the
surrounding neighborhoods are more likely to be referred for diagnostic services (and
subsequently positively identified, therefore, to receive intervention services): the AIC at work.
Consider the mechanisms at play in the diagnostic industry: very often, families are sent to
specialized autism centers for diagnostic evaluations—the very same centers that also happen to
offer intervention services. The financial conflict of interest is clear, in that positive identification
is financially incentivized, thus transforming a one-time client seeking diagnostic services into an
indefinite client seeking ongoing intervention services (and don’t worry—your health insurance
will cover it), yet this is a common route to obtaining an initial diagnosis as well as ongoing
ABA intervention for autistic children.
If California-based firms have an edge as competitors in the ABA industry marketplace, they
probably have O. I. Lovaas and his marketing and branding precocity to thank for that (and
Massachusetts, Skinner). Nevertheless, according to the hosts of the Autism Investor Summit
(which happens to be based in Los Angeles), the market for private equity investment in the
ABA industry is highly favorable, in part due to the market conditions of high demand for
intervention (a product of the success of the diagnostic industry and the successful
commodification of young autistic bodies), limited supply in relation to that demand (the scaling
up of private and corporate intervention service businesses appears to have lagged the scaling up
of diagnoses), a hospitable and predictable legislative environment across states facilitating
streamlined flows of health insurance dollars as revenue (thank you, Autism Speaks), a relatively
lax regulatory environment in many states (which provides investors the opportunity to directly
lobby for favorable regulatory environments as they emerge), and the potential for vast new
markets to be tapped for future profit extraction (including autistic children in economically
underserved and racially marginalized communities, as well as autistic adults—particularly
autistic women—that may have thus far escaped the dragnet of the diagnostic gaze of the AIC).
It does sound like an irresistible investment opportunity, doesn’t it?
Attendees at the second annual Autism Investor Summit in 2020 were treated to sessions
with titles such as: “The State of Autism Mergers & Acquisition: The Deals, The Data, &
Implications for Buyers & Sellers,” “Consolidation in the ABA Market—Considerations And
Implications,” “Current Trends in Payer Landscape: Value-Based Reimbursement,” “Risk &
Compliance: Considerations During Acquisition,” “Revenue Cycle Management,” “Deal
Structure: The ‘real’ value of a deal,” and my personal favorite: “ABA/Private Equity SPEED
DATING (limited spots—separate registration required)” (Autism Investor Summit, 2020).
Mergers, acquisitions, deals, buyers, sellers, consolidation, market considerations, payer
landscapes, value-based reimbursement, revenue cycle management, private equity . . .
Anybody still think this has nothing to do with capitalism?
But don’t take my word for it—maybe you’ll believe the capitalists. Even a cursory web
search will yield multiple current market analyses for the autism intervention sector designed to
help investors make well-informed (and profitable) investment decisions. And look out ABA—
the pharmaceutical industry is getting in on this very hot autism intervention market. For
example, the firm Market Research Future issued a report in February 2021 (under the
subheading “pharmaceuticals” on its website), titled Autism Disorder and Treatment Market
Information, further subtitled to include market analyses divided by “type” of autism, by
“treatment type” (e.g., ABA, etc.), and by “drug” (Market Research Future, 2021). The report is
not just regional, but provides global analyses of the autism intervention and treatment market
forecast through 2027. The front cover of the report states that “The global autism disorder &
treatment market is expected to reach USD 7,265.1 million by 2023” (Market Research Future,
2021). A global market of over US$7.2 billion by 2023? That might be worth getting in on.
Among the identified “drivers” of this market are: “rising prevalence” of autism, “expected
approvals of off-label drugs to treat” autism, and “rising government or privately held societies
taking initiatives to create the awareness about” autism (Market Research Future, 2021). The
“key players” identified in this report are all major pharmaceutical corporations, not all of them
American. Likewise, the firm Verified Market Research recently released a report titled Autism
Spectrum Disorder Diagnosis and Therapeutics Market Size and Forecast 2021–2028 (Watson,
2021). The scope of this forecast market analysis is also global, and nine of the 10 companies
featured in the report are also major pharmaceutical corporations. The tenth company is the
Center for Autism and Related Disorders (CARD), acquired in 2018 by the private equity firm
The Blackstone Group, Inc. Incidentally, the founder and executive director of CARD, Doreen
Granpeesheh, is herself a a protégée of O. I. Lovaas, and CARD primarily sells early intensive
ABA intervention. CARD, its staff members, and several clients were featured in the 2008 self-
produced and self-distributed film, Recovered: Journeys through the Autism Spectrum and Back
(Granpeesheh & Jaquis, 2008). Rhetoric in service of capital. And if you’re looking to invest, it
seems that perhaps both ABA and pharmaceutical intervention would be relatively profitable
subsectors of the industry in the near term. But then, what do I know? I’m a cynic. And maybe
not everything is about capitalism—but this is.

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CHAPTER EIGHT

Prevention, Inc.:
The Cultural Logic of Prevention, Basic Research,
Hedging Bets, and Perennial (re)Branding

I N THIS CHAPTER I explore the expansion and diversification of the AIC beyond the shorter-term
intervention industry (reliant upon autistic people as commodities) and into the longer-term
prevention industry (reliant merely upon the concept of autism and its ongoing constitution as a
threatening ontological category in order to generate profit). Specifically, I explore the
gargantuan economic investments (much of that, public dollars) in basic genetic and genomic
research, the hedging of bets in the prevention industry by funding not only basic research but
also research into whether vaccines precipitate autism (they don’t), and the ongoing, large-scale
investments in (re)branding and public relations as perennial and necessary business activities
within the autism industries. However, before examining the institutionalization of the specific
mechanisms and economic infrastructure of the autism prevention industry, I first examine the
expansion and rhetorical diversification of the AIC itself, expanding its cultural production of
foundational products beyond the commodification of existing autistic bodies and the cultural
logic of intervention, to include also the specter of future autistic people and the corollary
cultural logic of prevention.

Future Autistic People and the Cultural Logic of Prevention: Diversifying

Commodities

Recall Albrecht’s (1992) analysis of The Disability Business: its foundations consist in the
production of disability (in this case autism) as a social problem, coupled with the
institutionalized response to that problem. And as asserted in Chapter One, the cultural politics of
autism and the economics of autism co-constitute one another within neoliberal capitalism. At
least in part because the early conceptual and rhetorical foundations of the AIC were laid by
behaviorists (themselves interventionists), the foundational constitution of autism as “social
problem” consisted primarily in the very existence (and commodification) of autistic bodies, and
so the institutionalized response to that problem, thus constituted, was a coherent cultural logic
(and subsequent industry) of intervention. However, I have argued that the autism economy—the
buying and selling of goods and services, through commercial transactions that are generative of
profit—is actually an epiphenomenal feature of the AIC, better conceptualized as the autism
industry(ies). The lucrative autism intervention industry is by no means the only industry to be
spawned and sustained by the abundantly generative rhetorical and ideological architecture of the
AIC—but as the first, it did quite effectively serve as proof of concept, and additional autism
industries continue to emerge and proliferate from within the foundational rhetorical apparatus of
the AIC.
It was arguably behaviorists who explicitly introduced the economics of autism to the
broader public consciousness in such a way as to orient cultural modes of thought increasingly
toward futurity as it relates to autism and autistic people. As previously noted, Lovaas closed his
1987 treatment-effect study with a simple economic appeal as to the soundness of investing in
early behavioral intervention, and his was not the first. Nevertheless, the cost-benefit analysis he
presented made the argument that a substantial investment in early, intensive behavioral
intervention, however costly it may be, would nevertheless be far less costly than the spectral
prospect of the potential future cost of “life-long institutionalization” that likely awaited those
existing autistic children who, left “untreated,” would grow up to become autistic adults. It was a
short-term, though futures-oriented, calculation. Once the cultural logic of intervention took hold
and became hegemonic, it was but a very small rhetorical distance to traverse to arrive at the
corollary cultural logic of prevention: If autism as constituted is tragic, catastrophic, and hopeless
enough to warrant, without question, arguably invasive interventions, then why would we not
also seek to prevent people from “suffering” from autism in the first place? And perhaps the
spectral fear of future autistic people might also in and of itself serve to animate a different
industry, with a parallel set of markets (particularly once autism is successfully culturally
constituted as an “epidemic”). But how do we pursue (and capitalize upon) the hope of fewer (or,
conversely, the fear of more) future autistic people? How do we commodify not only the bodies
of existing autistic people, but also the abstract possibility of future others like them?
In December 2020, Sarah Zhang wrote a compelling feature article in The Atlantic titled,
“The Last Children of Down Syndrome: Prenatal Testing Is Changing Who Gets Born and Who
Doesn’t. This Is Just the Beginning.” Zhang reports that in 2004,

Denmark became one of the first countries in the world to offer prenatal Down syndrome screening to every pregnant
woman, regardless of age or other risk factors. Nearly all expecting mothers choose to take the test; of those who get a
Down syndrome diagnosis, more than 95 percent choose to abort. (Zhang, 2020, n.p.).

Further, she writes that in the 1970s, “when Denmark began offering prenatal testing for Down
syndrome to mothers over the age of 35, it was discussed in the context of saving money—as in,
the testing cost was less than that of institutionalizing a child with a disability for life” (sound
familiar?), and that “The stated purpose was ‘to prevent birth of children with severe, lifelong
disability’” (n.p.). Down syndrome is one of the simpler genetic conditions that is most
commonly tested for prenatally, because it most often involves the relatively straightforward
circumstance of an extra chromosome added to the 21st pair (Trisomy 21), and yet the tests are
not completely accurate, yielding both false positives and false negatives. It also happens to be
one of the more ethically controversial genetic conditions to prenatally screen for, precisely
because Down syndrome is among the least severe in terms of mortality or medical risk, though
its impact on a person’s life (in terms of health, language and communication, cognition, etc.) is
widely variable. And additionally, as Zhang puts it, Down syndrome is “very much compatible
with life—even a long, happy life” (n.p.).
Autism arguably has an even wider range of variability in its manifestations and
embodiments than does Down syndrome, is also very much compatible with a long, happy life,
and unlike Down syndrome, is not resultant from any straightforward or clearly identifiable
genetic variation. Consequently, one might expect the prospect of any kind of prenatal testing for
autism to be vastly less scientifically feasible than, and at least as ethically fraught as, testing for
Down syndrome. Nevertheless, as Zhang ominously cautions in her subtitle, this is just the
beginning:

Scientists have also started trying to understand more common conditions that are influenced by hundreds or even
thousands of genes: diabetes, heart disease, high cholesterol, cancer, and—much more controversially—mental illness and
autism. In late 2018, Genomic Prediction, a company in New Jersey, began offering to screen embryos for risk of
hundreds of conditions, including schizophrenia and intellectual disability, though it has since quietly backtracked on the
latter. The one test customers keep asking for, the company’s chief scientific officer told me, is for autism. The science
isn’t there yet, but the demand is. (Zhang, 2020, n.p.)

Indeed in one case a couple that already had two autistic children sought out Genomic
Prediction’s testing precisely because they wanted to have a third child (the next one, hopefully,
nonautistic), and they “hope the intelligence feature of the test” might somehow serve as a proxy
for identifying autism (despite having been counseled that such a test was unlikely to provide the
information they sought, or to function in that way) (Regalado, 2019, n.p.).
Nevertheless, and despite very preliminary and small and uncertain and as-yet unvalidated
data sets (and resistance from many geneticists), this for-profit startup has already “raised several
million dollars in venture capital” and is “preparing for a ‘massive marketing push’” (Regalado,
2019, n.p.). In many ways, this example of one very small private company may offer a pointed
reminder of the ways that, within an industrial complex, markets also (and often) drive science,
rather than the other way around. The autism prevention market did not emerge out of thin air,
nor was the cultural logic of prevention manufactured out of whole cloth, but rather, the broader
disability prevention industry was extant (if emergent) for many other disabilities and forms of
neurodivergence. Of course the autism industries want in on that market. Within this
contemporary cultural context (of the general valuing of “normalcy” and devaluing of any
“disability”), itself existing within deeply entrenched neoliberal capitalism, it is almost
impossible to imagine a world in which the AIC would not have spawned an autism prevention
industry, in addition to the autism intervention industry.
Just as behaviorism serendipitously happened to be contemporaneously ascendant with both
autism as an ontological category and neoliberal capitalism in the early decades of the emergence
of the AIC, so, too, did cultural interest in genetics happen to be ascendant during the late 1980s
and early 1990s, just as neoliberal capitalism became not ascendant, but entrenched as an
economic, epistemological, and ontological system. The Human Genome Project was launched
in 1990, after a number of years of exploration and planning, and in 2003, the project announced
its successful completion, more than two years ahead of schedule (Human Genome Project, n.d.).
The kinds of technologies being marketed by Genomic Prediction and other for-profit companies
in the broader disability prevention market may or may not ever successfully yield the “Gattaca
Babies” Regalado alludes to, but the prospect of high demand for products and services such as
those referenced by both Regalado and Zhang (e.g., a prenatal screening test for autism) are
nevertheless driving and scaling up the production of basic (both genetic and genomic) scientific
research in the prevention industry—an industry that arguably would not exist without (and that
is economically driven by) a hegemonic cultural logic of prevention in relation to autism.
Indeed, by the first decade of the century, the rhetorical architecture of the AIC already
served to simultaneously bolster the cultural logics of both intervention and prevention and,
therefore, to shore up both respective autism industries. In 2010, I published a piece titled
“Autism as Enemy” wherein I argued that the twin cultural metaphors of autism as epidemic
disease and autism as child abductor served the common cultural purposes of both establishing
autism as a cultural enemy and also fueling a strong sense of urgency, stemming directly from
the visceral fears that each of these menacing metaphors evokes. I argued that, taken together,

Each of these are necessary elements to successfully constitute autism as a cultural threat significant enough to support
particular approaches and postures toward both intervention (e.g., attempts at “recovery” through early intensive
behavioral intervention) and prevention (e.g., “curing autism” through identification of genetic markers coupled with
selective abortion), approaches that are themselves dominated by a proliferation of militaristic metaphors. (Broderick,
2010, p. 252)

And indeed that common militaristic rhetoric was institutionalized by 2006 in the Combating
Autism Act (CAA), described as a “multifront war on autism” by Autism Speaks (Broderick,
2010, p. 257), consisting of the first “front” of intervention (what I called militaristic “recovery”
operations) and the second “front” of prevention (what I called eugenic “eradication”
operations). Thus, fairly early on we see the common rhetorical infrastructure of the AIC being
used quite effectively to buttress the development of both the intervention and prevention
industries. And as was the case with the autism intervention industry, the economic engine
driving the autism prevention industry is arguably less the science or technology of it than it is
the powerful cultural logic of prevention.
The AIC, as a conceptual and rhetorical infrastructure, is once again proved to be abundantly
generative and, as such, spawns (and will no doubt continue to spawn) autism industries, not a
singular autism industry. And while the autism intervention industry is scaling up to take
advantage of relatively near-term market conditions while they last—e.g., ever-increasing
numbers of autism diagnoses (commodities in abundant supply, thus creating high demand for
intervention), coupled with a relatively unregulated and not-yet-saturated market of
interventionists (thus yielding high prospects for profit in the near- and mid-term)—the
prevention industry is playing a longer game, and its calculations effectively bet on futures
markets as an engine of both near-term and long-range profit potential. The prevention industry
operates as a significant economic engine in the near term in its own right, whether or not the
information and technologies it purports to seek (e.g., identifying the genetic bases of autism,
and therefore either gene therapies for treatment/cure/amelioration of autism and/or prenatal
testing that might identify and thereby prevent future autistic people from being born) ever
materialize.

Basic Research and Genomic Styles of Thought

Jennifer Singh (2016), in Multiple Autisms: Spectrums of Advocacy and Genomic Science, deftly
excavates the evolution of what I regard as the prevention sector of the autism industry. Singh’s
text is a compelling and interdisciplinary analysis of the billion-dollar industry of both genetic
and genomic autism research, an analysis that aims to investigate “the social, cultural, and
political factors contributing to the production, meanings, and use of genetic and genomic
knowledges of autism since the late twentieth century” (p. 1). And while she explicitly positions
her work as an exploration of social, cultural, and political forces at play in autism genetic and
genomic research, it is clear if implicit throughout her analysis that the economics operating in
this research sector are not only central and crucial to making sense of her analysis, but indeed
are arguably actually driving the evolution of this particular sector of industry. Singh (2016)
argues that there was a “growing consensus by 1998 that autism had a genetic component,” and
that since that time, “funding for autism genetics research has risen substantially” in the United
States (p. 3). The former claim is bolstered by Singh’s observation that in 1998, the Journal of
Autism and Developmental Disorders dedicated an entire special issue to justifying the pendulum
swing away from previous decades’ belief that autism was caused by poor parenting, trauma, or
environmental factors toward embracing the belief that “genetic factors do play an influential
role in the etiology of autism” (Fombonne, 1998, p. 349, cited in Singh, 2016, p. 203). Singh’s
latter claim is likewise amply illustrated:

For example, the Combating Autism Act (CAA) of 2006 allocated hundreds of millions of dollars toward genetic
research. Spending on the investigation of genetic risk factors alone accounted for over $100 million. Autism was also the
only disease earmarked for funds in the American Recovery and Reinvestment Act of 2009, granting approximately $30
million to establish the Autism Sequencing Collaboration. (p. 3, emphasis in original)

On the heels of the hundreds of millions of dollars appropriated by the CAA in 2006, Singh
documents further influx of funding for autism genetics research, noting that “by 2014 a private
philanthropy, the Simons Foundation, granted over $200 million dollars to autism research that
focuses mainly on genetics” (p. 3). “In short,” she argues, “by 2014 the investigation of autism
genetics became a billion-dollar scientific industry, and it continues to be a major funding
priority in the United States” (p. 4). More recently, in 2019, President Trump signed into law the
Autism Collaboration, Accountability, Research, Education and Support Act (a.k.a. the Autism
CARES Act, a reauthorization of the Autism CARES Act of 2014, itself a reauthorization and
renaming of the Combating Autism Act of 2006), which allocates $1.8 billion across fiscal years
2020–2024. The reauthorized law now requires the National Institutes of Health (NIH) to fund
research into developmental, behavioral, and clinical psychology, in addition to its extant
mandates to fund research into the neurobiology, genetics, and genomics of autism, thus feeding
and subsidizing both intervention and prevention industries with federal funding. (It should
additionally be noted that the 2019 CARES Act reauthorization also provides for NIH funding of
psychopharmacological research relative to autism, so my next analysis may well be of the
scaling up of the autism pharmaceutical industry) (Autism CARES Act, 2019).
Singh’s (2016) analysis meticulously documents the turn-of-the-century shift from genetic to
genomics research in autism: instead of continuing to look for a single or even multiple heritable
“autism genes,” as early genetic research on autism did (to little avail), a genomic reframing of
autism explores, rather, multiple “autisms” by exploring through molecular technologies
“microdeletions or duplications in the genome (called copy-number variants, or CNVs) that
[offer] new sites of investigation after failed attempts to identify specific genes for autism” (p. 8).
Singh characterizes the ways in which people and institutions, including governmental and
funding organizations, “perform concrete actions toward understanding disease at a genomic
level” as “genomic styles of thought” (p. 9). Singh argues that the shift from genetic to genomic
styles of thought is accomplished within “scientific, social, political, and economic
infrastructures” (p. 9), and cogently points out that “genomic styles of thought require extensive
financial investments” (p. 10). Recall Harvey’s (2007) assertion that in order for genetic,
genomic, or any other such “styles of thought” to become dominant, “a conceptual apparatus has
to be advanced” (p. 5), which, if successful, “becomes so embedded in common sense as to be
taken for granted and not open to question” (p. 5). These shifts in styles of thought are
accomplished through the work of a conceptual apparatus such as the AIC, and this emergent
(genomic) style of thought additionally requires substantial investments of capital.
Despite these substantial and now decades-long financial investments of both public and
private dollars in both genetic and genomic research on autism, according to Singh (2016),
“major genes for autism have not been found” (p. 4). Nevertheless, “public and private resource
commitments toward the goal of identifying genetic risk factors continue” (p. 4) at the expense
of other forms of autism-related research, including the exploration of issues deemed most
relevant by autistic people. Most autism research continues to be focused on autistic children, for
example, rather than foregrounding the research and policy priorities of autistic adults (Singh,
2016). For example, Singh reports that an audit (conducted by the U.S. federal Government
Accountability Office) of federally-funded autism research projects from 2008–2012 “found that
84% of projects were potentially duplicative and revealed excess funding in autism genetics
research,” including the National Institutes of Health (NIH) allocating “$86.6 million in sixty-
five projects to investigate genetic risk factors and candidate genes for autism” during the years
2008–2012, while during the same period the NIH allocated only “just over $11 million for
twelve projects” on “life-span issues” of concern to autistic adults (Singh, 2016, p. 18). Thus,
genetics research projects were funded during this time period at a rate of nearly eight times that
of research into life-span issues. While government and scientific funding is not precisely a zero-
sum game, this level of disproportionality in funding priorities is nevertheless noteworthy,
particularly when the higher prioritization of and investment in funding for genetic and genomic
research continues to yield very few of the initially sought outcomes.
Singh’s (2016) analysis asks why this substantial political, societal, and financial support for
autism genetic and genomic research has been so steadfast (despite very little fruition), how it
came to exist in the first place, and indeed what are the societal “consequences of viewing autism
as a genetic and genomic condition”? (p. 4). Importantly, Singh also explores the “various
meanings and subjectivities developed or interrupted based on autism genetic and/or genomic
knowledge,” and shows in her analysis “how despite the billion-dollar pursuit of unravelling the
genetic cause of autism, the understanding of autism remains elusive and the utility of this
information has limited value in the immediate lives of people living with autism” (p. 5). In
many ways Singh’s analysis parallels my own analysis of the AIC, in that she sought to make the
familiar (the routine monetization of autism, in this case through pursuit of basic genetic and
genomic research) strange, to explore how such conditions came to be and who participated in
their evolution. Additionally, and crucially, Singh’s analysis also parallels my own through her
exploration of the ways that these material (economic) conditions not only generate revenue and
sustain a large-scale industry, but also both “develop” and “interrupt” particular autistic identities
and subjectivities within that epistemic and ideological and economic architecture. And the
obvious follow-up question to this exploration then becomes, “who, therefore, is benefitting from
this billion-dollar investment in genetic and genomic research on autism?” It seems unlikely that
the answer is “autistic people.”

Building Prevention, Inc.

In the preceding chapters, I identified four key networks of plutocratic players in developing the
architecture of the AIC, specifically in establishing the autism intervention industry, which the
AIC originally evolved to shore up: (a) academic behaviorists, (b) nonautistic parents of autistic
children, (c) the Behavior Analyst Certification Board® (BACB®), and (d) Autism Speaks. A
similar, overlapping, though slightly different network of plutocratic players has driven the
parallel (if slightly later) development of the economic and policy architecture establishing the
autism prevention industry. The key overlapping players in both of these sectors are (a)
nonautistic parents of autistic children and (b) Autism Speaks, each of which continues to be a
driving force in both the intervention and the prevention industries. The BACB, as a nonprofit
corporation whose sole purpose is to create and certify a cadre of professionals who will be
employed by the intervention industry, has played no real role in the establishment of the
prevention industry (as ought to be expected). Indeed the intervention industry could
theoretically go from boom to bust if there does not continue to be an adequate and ever-growing
(thank you, diagnostic industry subsector) supply of autistic people as its foundational
commodity. Likewise, academic behaviorists have played next to no role in the “institutional
response” of the prevention industry. In the prevention industry, the role of behaviorists is
played, rather, by geneticists and other scientists, and in this sector, the parents (rather than the
professionals) have driven the establishment of the industry.
In the evolution of the intervention industry, well-positioned (e.g., White, affluent,
nonautistic) parents of autistic children formed alliances with behaviorist researchers and later
worked together to form multiple autism nonprofits (for the purposes of both tapping into and
streamlining access to funding sources as well as generating a sympathetic media and PR climate
for their efforts). Similarly, Singh (2016) documents the pivotal role that well-positioned parents
also played in establishing the contours of the prevention arm of the AIC (what Singh refers to
simply as autism genetic and genomic science). Singh carefully documents what she calls the
“riveting history of parent advocates who spring-boarded off the work of Rimland and the NSAC
to build an epistemic infrastructure of autism genomic science” (p. 35). The history to which she
refers I discussed in depth in Chapter Two, and has been discussed in even greater depth by
others (e.g., Eyal et al., 2010; Silverman, 2012). I argue here that the parents whose advocacy
work Singh traces built upon the existing parent advocacy movement to build not only an
epistemic, but also an economic infrastructure through the institutionalization of genetic and
genomic research as the basic research foundations of the prevention industry. I refer the reader
to Singh’s detailed analysis, the nuance of which is well worth reading. However, here I will
note that Singh (2016) cites Portia Iverson, nonautistic parent of an autistic child and co-founder
of Cure Autism Now (CAN) as stating that “in 1995 fewer than five million dollars a year were
spent on autism research” (p. 37). Today, autism research is a billion-dollar industry, and
thousands of researchers around the globe are actively involved in the production of autism
science and research.
Singh points out that these parent advocacy efforts “required the establishment of multiple
partnerships to advance science on autism with the hope of uncovering its root causes and
ultimately a cure” (p. 37). Further, Singh argues that the significant scaling up of the autism
basic research industry in the past several decades was “fueled by grassroots efforts driven
initially by parent advocates whose children were given autism diagnoses and limited hope for
the future” (p. 37). Situated within the historical context of the relative dearth of cultural hope in
relation to autism, Singh traces the history of the organizations National Alliance for Autism
Research (NAAR) and CAN, which sprang up on the east and west coasts of the United States,
respectively, in the mid-1990s. However, both of these advocacy organizations also emerged in
the early years of the Human Genome Project, at a time when the hype surrounding the
sequencing of the human genome generated powerful cultural hopes that the project would yield
significant advancements in both treatment and prevention of human diseases, including autism,
which at that time was increasingly being framed within both disease and genetic discourses.
The parents who initiated and formed NAAR and CAN were well positioned in terms of
cultural capital and privilege (e.g., they were White, affluent professionals working in medicine,
law, and Hollywood), but they were not precisely plutocrats when they initiated their early
advocacy efforts. From the mid-1990s through the mid-2000s, these two organizations succeeded
in remaking the landscape of autism advocacy, bringing together into partnerships families of
autistic children, genetic scientists, and crucially—a range of both “public and private funders”
(Singh, 2016, p. 58). The early partnerships in the intervention industry had also involved
partnerships between both parents and researchers (behavioral, in that case), but a primary role of
the nonprofit organizations was to seek and facilitate access to existing sources of funding (e.g.,
health insurance dollars) for individualized access to intervention resources. In the case of the
prevention industry, early parent advocacy efforts involved the establishment of their own
nonprofits to facilitate large-scale fundraising, specifically to sponsor and fund scientists to
conduct basic genetic and later genomic research. The architecture was different, because the
funding and infrastructure for the prevention industry differed from those of the intervention
industry. By raising private funds and then deploying those funds to directly support scientists
(many of them early career) in conducting genetic research on autism, NAAR and CAN shifted
“the balance of power between parent advocacy groups and scientists” (Singh, 2016, p. 61).
Indeed the parents who formed NAAR and CAN did not wait for scientists to lead the way—they
raised the money, set up their own genetic databases, and invited scientists to accept the offered
funding for conducting genetic research that was in alignment with the parents’ priorities. For a
decade, during the early years of the Human Genome Project, these parent-led advocacy groups
succeeded in getting genetic research on autism both funded and on the map.
Thus, building upon the same foundational rhetorical, conceptual, and epistemological
infrastructure (of the AIC) as the intervention industry, the autism prevention industry has
experienced a slightly different trajectory in its development, even though key and overlapping
networks of players participated in both. While both industries relied heavily upon the same
conceptual and rhetorical apparatus of autism being culturally constituted as dangerous, tragic,
catastrophic, etc., primarily in order to better “animate” funding sources, the labor of these
networks in establishing the economic apparatus of the prevention industry differed in several
significant ways from the labor involved in establishing the intervention industry described in the
last chapter. For example, the employment infrastructure of basic research as an industry (e.g.,
the professional preparation of research scientists, laboratory technicians, etc.) was extant, and
these occupations and professions did not need to be created, certified, or licensed in order for
the autism prevention industry to take hold. This of course differs from the perceived need within
the field of behavior analysis to create multiple stratified levels of behavior analysts and the
newly created paraprofessional role of behavior technician, in order for the intervention industry
to take hold as a viable large-scale sector of commerce. Thus, the prevention industry in many
ways emerged as a rhizomatic side-shoot of the architecture of the AIC, the initial foundations of
which were built by and in support of the intervention industry, but the ideological and rhetorical
architecture of which were well-established enough to generate and support the development of
multiple parallel autism industries. By the time the nonprofit Autism Speaks incorporated in
2005, both of these industries were significantly scaling up, and from its inception, Autism
Speaks worked to support both of these emergent autism industries.

Autism Speaks and Hedging One’s Bets

Just as Autism Speaks played an outsized role in establishing the architecture of the autism
intervention industry, so, too, did it play a significant role in institutionalizing the economic
architecture of the autism prevention industry. However, as a nonprofit, that role continues to be
one of consolidation and centralization of resources, fundraising, and public relations and
branding (and lobbying, though not “substantial” lobbying, apparently). Autism Speaks initiated
neither the development of the AIC nor the early establishment of the economic architecture of
the intervention industry; similarly, it did not precipitate the institutionalization of the prevention
industry’s funding apparatus. Nevertheless, the folks at Autism Speaks do know a thing or two
about acquisitions, fundraising, public (media) relations, lobbying, and branding, and thus the
organization continues to be a central pillar of the AIC, which itself continues to spawn ever-
diversifying autism industries.
Autism Speaks has long proven itself to be in the business of hedging its bets, and its shaping
of the contours of the prevention industry illustrates that strategy. How might one go about
preventing autism? The answer to that depends, in large part, on whether autistic people are born
or made. Recall Kanner’s (1943) initial claim that autism was “inborn” and the subsequent
hypothesizing by Bettelheim and others that autism was, rather, a psychological “withdrawal”
from the trauma of cold or unresponsive parenting. And while few would currently offer up
Bettelheim’s refrigerator mother theory without expecting to be scoffed at, many people are still
willing to offer up multiple other hypothesized precipitating events that fall into the general
category of autism (and therefore, autistic people) being made, rather than born. Indeed the
metaphors and images that have been used to describe (or more precisely, imagine) autistic
experience over the past many decades reflect this ongoing shifting in conceptualization of what
autism is (Broderick & Ne’eman, 2008). It turns out, perhaps, that autism is as autism does.
When Autism Speaks incorporated in 2005, it billed itself as North America’s “largest autism
science and advocacy organization,” and it very quickly set about making its “largest” claim
quite accurate by acquiring, in its first two years, both NAAR and CAN and subsuming them
(neoliberal Pac-Man style) within the media behemoth Autism Speaks. In so doing, Autism
Speaks thereby also consumed and consolidated within itself the two largest initiatives and
databases related to genetic research on autism: the Autism Genome Project (AGP) and the
Autism Genetic Resource Exchange (AGRE). A substantial investment was made in cornering
and leading (by acquisition) funding into genetic and subsequently genomic autism research, and
thus the ledger demonstrated investment in the “nature” (autistic people are born, not made) side
of the debate. However, in its first decade, Autism Speaks also hedged its bets on the eventual
contours of the prevention industry by continuing to invest funding in the “environment”
(autistic people are made, not born) side of the debate/ledger, and in so doing, went down a
rabbit-hole or two in its funding priorities, apparently driven in part by its culture war quest to
“eradicate” autism and its founders’ own personal beliefs about the origins of their grandson’s
autism. Indeed these funding priorities arguably jeopardized Autism Speaks’s own credibility
and branding as a “scientific” organization, and without doubt led to an exodus of key members
of its own leadership within the organization’s first five years.
Until reversing its position in 2015, Autism Speaks had for nearly a decade pursued an
agenda that, in part, funded “scientific” research seeking to explore possible links between
autism and vaccines, an agenda that provided oxygen to conspiracy theories fueled by the
fraudulent and subsequently fully retracted 1998 work of Andrew Wakefied et al. in the British
medical journal the Lancet, which had suggested that there may be a link between the MMR
vaccine, gastroenterological disease, and autism. The Lancet partially retracted the paper in 2004
(a year before Autism Speaks incorporated), and fully retracted it in 2010, based upon
Wakefield’s alleged ethical improprieties, undisclosed financial conflicts of interest, and
fraudulent manipulation of data. Wakefield apparently failed to disclose to the Lancet prior to
publication that he stood poised to personally and substantially profit from the cultural fear of the
MMR vaccine potentially causing autism by holding a patent for monovalent alternatives to
MMR. All industries are susceptible to corruption, particularly within neoliberalism; why should
the autism industries be any different than others in that regard? The reader is directed to Deer
(2020) for an exhaustive and meticulously documented investigative journalistic account of this
most shameful and far-reaching example of medical and scientific fraud that attempted to
capitalize on the pervasive cultural logic of prevention of autism within the AIC. Wakefield’s
publication substantially contributed to the cultural rhetoric and fearmongering that shored up
(and unfortunately, continues to shore up, even after its retraction) the ideological foundations of
the cultural logic of prevention within the AIC, and the media giant Autism Speaks’s
equivocation on the question of the relationship between vaccines and autism did little to
mitigate the circulation of this damaging disinformation in popular discourse and rhetoric.
Science is as science does. Recall Haack’s reminder that “much scientific work is unimaginative
or banal, some is weak or careless, and some is outright corrupt . . . for knowledge is power, as
[Francis] Bacon saw, and power can be abused” (pp. 75–76).
Finally, in 2015, a full 5 years after the Lancet’s retraction of Wakefield’s discredited paper
(and the consequent revocation of Wakefield’s license to practice medicine), Autism Speaks
issued a clear statement from its chief science officer, Rob Ring (a former neuroscientist at
Pfizer): “Over the last two decades, extensive research has asked whether there is any link
between childhood vaccinations and autism. The results of this research are clear: Vaccines do
not cause autism. We urge that all children be fully vaccinated” (Diament, 2015, n.p.). Better late
than never. The neutral tone of the statement labors to give the impression that perhaps the jury
on the science had still been out until 2015 when the statement was issued, and Autism Speaks
had simply been waiting for science to do its work before taking a definitive position on the
matter. However, a consequence of this rhetorical decision is the perception (accurate or not) that
during those 5 years Autism Speaks was not waiting for the science to lead the industry, but
rather continuing to hedge its own bets on which sector of the prevention industry would pan out
(genetic or environmental), and continuing to fund research in both of these areas. This years-
long silence before finally repudiating the vaccine conspiracy theories (all the while continuing
to brand itself as a “science” organization) was not without consequence for the organization’s
talent nor its reputation.

Autism Science Foundation: Jumping Ship and Reclaiming Science

Even before the Lancet retracted Wakefield’s manuscript in 2010, the writing had been on the
wall for a number of years as to the actual scientific data exploring possible links between
vaccines and autism. Eric London, a psychiatrist and parent of an autistic son, who with his wife
Karen had cofounded NAAR in 1994, had joined the scientific and executive advisory boards of
Autism Speaks after it acquired NAAR in 2006 (Singh, 2016). During the years between the
founding of NAAR and its merger with Autism Speaks, there had been intense cultural interest in
explorations of any possible links between autism and vaccines, significantly fueled by pressure
from parents of autistic children, despite publication of several comprehensive studies that
showed no causal link. Nevertheless, according to Singh (2016), when the most comprehensive
of these (the Institute of Medicine report in 2004) was published,
Autism Speaks prioritized vaccine research, which a range of stakeholders felt was a complete waste of time, including
Eric London. Thus, in 2009 he resigned from his position and affiliation with Autism Speaks . . . . London’s resignation
letter indicated that the pivotal issue compelling his departure was the position of Autism Speaks on vaccinations and
their investment and advocacy for research on the rare cases of “biologically plausible” vaccine involvement in autism
causation. (p. 45)

Since leaving Autism Speaks, London has served on the advisory board of the Autism Science
Foundation (ASF), co-founded by his wife Karen London and Alison Tepper Singer, also a
parent of an autistic child, who also “resigned from her position as executive vice president of
Autism Speaks due to disagreement on supporting research into possible links between vaccines
and the onset of autism” (Singh, 2016, p. 45). Unlike the Londons, who had joined forces with
Autism Speaks in 2006 subsequent to its acquisition of NAAR, Singer had been with Autism
Speaks from its inception in 2005, having been recruited by Bob Wright from within the media
organization he led, NBC Universal. And although she had been a central and leading and highly
visible figure in the leadership of Autism Speaks for its first several years, particularly in its
media productions (see, for example, the 2006 film, Autism Every Day [Thierry, 2006]), by 2009
Alison Tepper Singer had left Autism Speaks to co-found the ASF, preferring to focus her efforts
on funding scientific research, rather than the many additional priorities of Autism Speaks (e.g.,
policy and legislative lobbying, large-scale media initiatives, etc.) (Earle, 2020).
The underlying reason for Singer’s and the Londons’ departure from Autism Speaks is
clearly, if implicitly, branded in the founding mission of ASF. The organization’s stated mission
is premised on three central “facts”: the first, that “autism is known to have a strong genetic
component” and that genetic research should therefore seek to better understand the mechanisms
that “trigger autism” as well as to develop treatments to enhance quality of life for autistic
people; the second, that “science has a critical role to play in creating evidence-based, effective
[both early and] lifespan interventions;” the third, that “vaccines save lives; they do not cause
autism,” and that “further investment of limited autism research dollars is not warranted at this
time” (Autism Science Foundation, n.d.b). Thus, the overarching mission of ASF is clear: We
will fund genetic research into causes and types of autism; we will also fund genetically
informed intervention research; we do not fund vaccine-related research, period.
The ASF is decidedly more nuanced than Autism Speaks in its pursuit and funding of genetic
research into the ways that different autisms may be “triggered,” thereby conceptually braiding
together the logics of both intervention and prevention under the umbrella of genetic science.
And unlike Autism Speaks, ASF has not trafficked in eugenic rhetoric about “eradicating” or
“curing” autism, nor indulged (by funding) conspiracy theories related to autism and vaccines. In
the spirit of giving credit where credit is due, my hat’s off to both the Londons and Singer for
seceding from Autism Speaks when they did. I may very well be wrong, but from the outside
looking in, I would not be surprised if there were additional substantive disagreements (above
and beyond distancing themselves from vaccine/autism conspiracy theories) that informed their
decisions, including, perhaps, a discomfort with the eugenic undertones of the rhetoric of
eradicating autism, eventual dissatisfaction with the cult-like devotion to ABA intervention, and
perhaps even being fatigued by the relentless media circus that is Autism Speaks.
ASF is not a media production conglomerate in the ways that Autism Speaks is; it keeps its
head down and funds mostly genetic research, but it is without question an example of neoliberal
venture philanthropy, sometimes called philanthro-capitalism (Leibel, 2009, cited by Picciano &
Spring, 2012, pp. 120–121). Singer herself has a background in business and economics as well
as media, and the current chairman of the ASF board is Gregg E. Ireland, “formerly a Senior
Vice President of Capital World Investors, a division of Capital Research and Management
Company. CRMC is the Investment advisor for the American Funds with $1 trillion under
management” (Autism Science Foundation, n.d.a). ASF appears to be well-positioned to
leverage its executives’ personal and professional connections to the wealth and influence of
Wall Street, including by hosting its annual “Wall Street Rides FAR (for autism research)”
fundraising bicycle rides (a variation on the perennial fundraising “walk” of Autism Speaks and
many other major philanthropic organizations). Over three dozen Wall Street firms, dealing in
securities, capital investment, financial advising, and other sectors of finance—as well as the
NYSE and Nasdaq exchanges—sponsor the annual event.
Thus, I cannot but also analyze ASF through the lens of neoliberal capital—what is their
market, their brand, their business plan? And yes, it goes without saying that the Londons and
Singer are parent (and sibling) advocates who have devoted their adult lives to autism advocacy
and research. And yet, it is also the case that such advocacy and research endeavors exist within
neoliberal capitalism, and those that are successful in their efforts are generally those who are
skilled at neoliberal capitalism as much as anything else. The branding and the market are
relatively clear—they have worked to distinguish themselves and their efforts from those of
Autism Speaks by carving out a much narrower mission (that does not include large-scale policy
or legislative lobbying, and that does not preclude small-scale media/“awareness” initiatives), by
explicitly excluding from that mission any funding of vaccine-related research and by branding
their foundation as pursuing “autism science.” And although the latter reads as an explicit
branding maneuver, it is decidedly less scientistic than similar-sounding branding initiatives
working to establish the intervention industry in the previous decade (e.g., and not to be confused
with, the Association for Science in Autism Treatment [ASAT] discussed in Chapter Five, an
association founded in 1998 and aligned with promoting and disseminating the “science” of
ABA, etc.).
Rather than searching for some sort of magic bullet that will either prevent autism entirely
(e.g., prenatal testing) or “recover” existing autistic people (e.g., ABA), the ASF appears to be
carving out for itself a more complex and nuanced—and actually scientific—intersection of the
intervention and prevention markets, one that seeks the possibility of targeted, presumably
scalable treatments specifically aimed at ameliorating facets of specific types of the many
“autisms” (Singh, 2016), as identified by increasingly precise genetic and genomic analyses of
autism. In a recent interview, Singer said of ASF:

We fund research—university-based research—to understand the genetic causes of autism, the environmental causes of
autism, how genes and environment interact to cause autism. And then we fund clinical trials of treatments that are really
targeted to that underlying biology. (Earle, 2020)

In that same interview, Singer was asked where she saw the science of autism going in the next
decade, and this was her response:

So we are learning more and more every day about the genes that cause autism. And as we continue to invest in genetics
research, we will find the genes that cause autism in more and more people. And we will be able to conduct studies based
on more groups with the same type of genetic deletion or disorders. So I think we will move towards a more personalized
approach. It won’t just be, if you’re diagnosed with autism, you get applied behavior analysis. There will be very targeted
medications based on your underlying biology. And there will be many different types of behavioral interventions that are
based upon your strengths and your weaknesses and the areas where you need to improve, rather than just saying
everyone with autism gets ABA. So we used to be in sort of a one size fits all, and we’re moving towards a much more
personalized approach—an individualized approach for everyone. (Earle, 2020)

There will be very targeted medications based on your underlying biology. Do you remember the
2019 reauthorization of the autism CARES Act—can you remember the additional named areas
of research targeted for federal NIH funding? Most attention at the time of the reauthorization
was paid to the expansion of funding for behavioral research, in addition to existing
prioritizations of genetic and genomic research. However, an additional sector of research was
targeted to receive government funding: psychopharmacological. The autism pharmaceutical
industry is preparing to scale up (see the market analyses discussed at the end of Chapter Seven,
and Morris’s 2018 blog about the autism boom), and the research funded by the ASF may enable
that industry to move to scale more rapidly as soon as the scientific data begin to support
particular treatment interventions (and hopefully not before). In the near term, much of the
research funded by ASF appears to better undergird the diagnostic (rather than intervention or
prevention) industry (Autism Science Foundation, n.d.c); however, the targeted and personalized
models of intervention and treatment (or potentially prevention) conceptualized by ASF are of
course dependent upon quite precise diagnostic capabilities to discern among the many and
varied “types” of autism(s) that appear to be lumped into a single ontological category.
That said, while the ASF may have been formed as an explicit departure from and distancing
of Autism Speaks’s research priorities, its branding, etc., ASF’s mission is presently not terribly
different from the current mission of Autism Speaks. Since London and Singer left Autism
Speaks in 2009, the organization has shifted, evolved, grown—and more to the point, rebranded
—in part (apparently) based on what it’s learned from those who departed. For example, in a
statement on its webpage titled “For the Record,” Autism Speaks presently concedes that
research, both internally and externally funded, has shown “that there is no single ‘autism’” and
that “science also tells us there will be no single ‘cure’.” The statement goes on:

Today, Autism Speaks is not looking for a cure, and in fact, in 2016, the word “cure” was removed from our mission
statement. What Autism Speaks is seeking is research advancements that improve the quality of life for autistic people
today and appropriate personalized treatments in the future. We remain committed to understanding the causes of autism
and accelerating progress toward personalized treatments. (Autism Speaks, n.d.a)

Sound familiar? The eugenic rhetoric around cure and eradication of autism has been largely
jettisoned, the funding of vaccine-related research appears to have stopped, and the organization
has finally seemed to acknowledge that autistic adults both exist and are deserving of good
quality of life. Its legislative lobbying efforts have likewise been entirely rebranded as grassroots
advocacy, and we seem to find a kinder, gentler Autism Speaks in 2020 than took the autism
world by storm in 2005. Autism Speaks seems to have actually learned a thing or two along the
way from some of the folks who have left the organization in protest, but perhaps the most
powerful lesson they’ve learned is the benefit of greater subtlety, nuance, and adaptability in
their own branding.

Autism Speaks and Perennial Rebranding

In 2020, after 15 years of operations, Autism Speaks underwent a significant rebranding

initiative. And although the organization has not always proven to be nimble enough when it
comes to branding and media and PR (the epidemic and child abduction rhetoric, ultimately, may
have done the brand more harm than good, and its failure to take a firm stand on the
autism/MMR vaccine debacle until it was long past due are notable examples), it has
nevertheless proved its own staying power (Autism Speaks isn’t going away any time soon), its
own capacity to rebrand when it decides it’s time, and its long reach globally as a multinational
nonprofit corporation.
Autism Speaks visually marked its rebranding campaign (and yes, it calls it “rebranding”
itself, I am not imposing that rhetoric upon it) by updating its iconic blue puzzle piece logo to
reflect a spectrum of color in addition to the still-dominant Autism Speaks blue. According to the
organization, the updated logo “signifies the diversity of perspectives and experiences with
autism spectrum disorder and signals a deepened commitment to inclusivity” (Autism Speaks,
2020a). According to president and CEO Angela Geiger,

Over the years, we have heard from the vast and diverse autism community—from our supporters to our critics, and from
those whose autism is their greatest strength to those for whom autism can be a daily challenge. This new look aims to
highlight the depth, breadth and infinite differences along the autism spectrum and to show our commitment to listening,
evolving, and reflecting those we serve. (Autism Speaks, 2020a)

The commitment to “listening” is a welcome feature of the rebrand and contrasts with the initial
Autism Speaks logo that included the tagline beneath the puzzle piece, “It’s time to listen.”
Presumably (and evidently), the original branding expected that everyone else would be listening
to Autism Speaks, and after many years of autistic activists pointing out that Autism Speaks
steadfastly did not listen to the people they purportedly spoke for (autistic people), they have
perhaps wisely decided to rebrand as an organization that “listens” and “serves,” rather than one
that attempts to eradicate or cure whilst ignoring autistic people’s calls for representation within
the organization. Additionally, the rebranded Autism Speaks now concerns itself with “lifespan”
issues, or the priorities of autistic adults, rather than almost exclusively focusing on advocacy
efforts related to autistic children, as it had for the first 15 years.
Before giving credit to the impact of autistic adults’ activism over those 15 years or the
responsiveness of the organization to that constituency (finally), it should perhaps be noted that
this facet of the rebrand happened to coincide with the coming of age of the founders’ grandson,
Christian, who had been 3 years old when the Wrights founded Autism Speaks. Now that
Christian is a young adult (and is, presumably, still autistic), one can only imagine that the
perspective of the organization will have evolved to continue to reflect the perspective on
advocacy held throughout the organization’s first 15 years—that of the founders’ perspective of
their grandson. Welcome, Christian, to autistic adulthood—or “adulting,” per Autism Speaks’s
new Facebook group (Adulting on the Spectrum, n.d.).
According to a press release from the organization,

In concert with the rebrand, we’re launching our birthday wish: to create a kinder world for people with autism. We’re
calling it our “Year of Kindness” initiative: challenging our community to complete one million acts of kindness by the
end of 2020. (Autism Speaks, 2020b)

The “new” Autism Speaks is “kinder,” more “inclusive,” it is a listening, evolving, and learning
organization. The new vision of the new Autism Speaks? “A world where all people with autism
can reach their full potential” (Autism Speaks n.d.b)—very, very different messaging from
Suzanne Wright’s early vision of a world where “autism is a word in the history books.”
Suzanne Wright was diagnosed with pancreatic cancer in 2015 and died in 2016. Her
husband, Bob Wright, stepped down from his leadership position at Autism Speaks in 2015. The
statement from Autism Speaks confirming that vaccines do not cause autism was issued in 2015.
The organization’s partnership with Google, launched in late 2014, to develop a freely accessible
online database of the complete genomes of 10,000 autistic people and their families (MSSNG)
(a repurposing of the repositories of genetic information Autism Speaks obtained in its
acquisition of NAAR and CAN), was largely up and running and accessible to researchers by
2016. Autism Speaks had achieved almost unimaginable accomplishments for a nonprofit in its
first 15 years, but at some not insignificant reputational cost. It was high time to retrench, reboot,
rebrand. The rebranding announcement closed by saying, “We hope that this effort, together with
our more inclusive look, will fuel an atmosphere of kindness that can last for many more years to
come. And we invite you to join us!” (Autism Speaks, 2020b). Reputational currency is valuable
and well worth investing in and retrenching for. Perhaps this rebranding effort, and the new
“inclusive” logo will last them for many more years to come. And if not, I think they probably
know some media and PR people who can donate in-kind resources to assist with that when they
need it yet again . . . . .

You Might Be an Industrial Complex If . . .

Picciano and Spring (2012), in The Great American Education-Industrial Complex, draw upon
Wedel’s (2009) discussion of what she called the “shadow elite.” Wedel’s text analyzed what she
argued was “a new form of global governance based on networks of governments, educational
institutions, and for-profit companies (Wedel, 2009)” (Picciano & Spring, 2012, p. 15). As
discussed in Picciano and Spring, Wedel’s analysis argued that these networks are made up of
people termed flexians, or what Wedel (2009) calls “the actors moving through the networks
between these global institutions” (p. 15). Within these networks comprising shadow elites (or
what I call foundational plutocrats in the AIC), flexians move through and among the networks
of private (for-profit) industry, government bureaucracy, and private foundations and nonprofit
corporations. Thus, while most flexians “promote their own interests and sometimes those of for-
profit companies” (Picciano & Spring, 2012, p. 15), they also, because of their movements
among these various networks, tend to have personal relationships with government bureaucrats
as well as corporate and private foundation executives, relationships that tend to be both
cultivated and deployed in furtherance of political (economic) aims.
Alison Tepper Singer is a good example of a well-connected flexian who moves between and
among the various networks of private foundations, nonprofit corporations, government
agencies, and for-profit entities operating in the various autism industries that are currently
thriving thanks to the decades-long investments of the AIC. As both a parent and sibling of
autistic people, she is unquestionably working in furtherance of her lifelong labors to improve
the lives of autistic people, even if she may yet be justly criticized for some of the ways she
advanced that agenda while CEO at Autism Speaks (see Broderick, 2010). She has served
multiple terms as a representative on the Interagency Autism Coordinating Committee (IACC),
the inter-agency governmental committee established by the CAA in 2006 to coordinate autism
policy at the federal level. She has both founded and filled executive leadership roles in
nonprofits and private foundations, and her professional background in both business and media
have yielded enduring connections to corporate media and to Wall Street (the latter primarily as a
funding source to be tapped), in addition to her connections within the federal government.
So, too, might Robert Ring be an instructive example of a well-connected AIC flexian,
although he would appear to be less well-connected to government and vastly better connected to
investment capital than Singer. Ring served at Autism Speaks from 2011–2016, first as vice
president and head of translational research, and subsequently as chief science officer (CSO).
According to Ring’s own public LinkedIn profile, Autism Speaks co-founder Bob Wright, in his
autobiography, described Ring as “a neuroscientist with the sensibilities of a venture capitalist
and the heart of a researcher” (Ring, n.d). Having the heart of a researcher will not necessarily
get you all that far today (which Ring perhaps realized during his early career as an adjunct
professor and self-employed artist), but, if coupled with the sensibilities of a venture capitalist,
Ring’s CV begins to make a great deal more sense. Prior to his position as CSO of Autism
Speaks, Ring was head of the Autism Research Unit at Pfizer for three years, where he “led
Pfizer’s groundbreaking new therapeutic area research unit focused on the discovery and
development of medicines for neurodevelopmental disorders: At the time, among large pharma’s
earliest dedicated units invested in pursuing therapeutic opportunities across the autism
spectrum” (Ring, n.d.). (Perhaps having a neuroscientist from Big Pharma provided the nudge
Autism Speaks needed to finally state their concession that vaccines do not cause autism?) And
while at Autism Speaks, he simultaneously presided over Delivering Scientific Innovation for
Autism LLC (DELSIA), a “not-for-profit venture philanthropy affiliate of Autism Speaks.”
Ring left Autism Speaks in early 2016 to found and preside over his own firm called Autós
Consulting and Advisory Solutions. According to Ring’s profile,

Autós provides consultancy and advisory services to clients across the life sciences ecosystem, including biopharma,
newcos, nonprofit foundations, private investors, philanthropists and venture funds. Autós draws on extensive experience
with psychiatric and neurological disorders, and specializes in rare (orphan) diseases of the CNS, including the autism
spectrum and related neurodevelopmental disorders. (Ring, n.d.)

His most recent (and concurrent) venture has been serving as the chief executive officer of the
U.K.-based firm Kaerus Bioscience Ltd., described by Ring as “an early biotechnology company
developing genetically-targeted therapeutics for rare neurodevelopmental disorders across the
autism spectrum” (Ring, n.d.). In Ring’s introductory profile (“About”), he describes himself as
an “innovator,” possessing “unique leadership experience spanning executive, strategic and
technical roles in the pharmaceutical industry, nonprofit sector, and venture philanthropy space,”
and with a “track record of accomplishment and collaboration across all stages of the
translational research value chain.” Thus, he would seem to be an accomplished flexian, moving
easily among (and with ties to and relationships with) the sectors of basic neuroscience, the
corporate pharmaceutical industry, nonprofit corporations, and venture capital and venture
philanthropy.
I intend no disparagement in pointing out either Singer’s or Ring’s connections as flexians to
these various interconnected sectors within the AIC and autism industries. These relationships
have arguably enabled Singer to have a greater impact upon her chosen field of advocacy than
any well-intended parent without similar connections could hope to have had and Ring to have
had similarly greater impact upon his chosen professional aims than any neuroscientist working
at a research university or a clinic might hope to have. There is nothing inherently nefarious in
operating as a flexian. Similarly, there is nothing inherently corrupt in operating as a venture
capitalist. The caution must arise when one examines not the individual players within these
networks, but rather, the ways that the networks themselves have emerged, the power deployed
through these somewhat opaque connections, and the inherent potential for corruption or abuse
of power, should the individuals operating within these networks not have the upstanding moral
character of a Singer or of a Ring (but rather, perhaps, that of a Wakefield . . . ).
This emergent form of global governance by shadow elites (Wedel, 2009), in part achieved
by the movement through these networks by well-connected flexians, is itself a logical and
almost inevitable outgrowth of neoliberalism, in which the state is conceptualized primarily as a
source of public revenue to be harvested and a set of tools (legislative, regulatory, etc.) to be
deployed by and in the interests of private or corporate industry. In many ways my own analysis
of the AIC dovetails with both Wedel’s (2009) and Picciano and Spring’s (2012) arguments. I
have attempted herein to analyze, rather than demonize, the ways that the autism industries have
both emerged and flourished in recent decades out of the rhetorical, ideological, and media
architecture of the AIC. Within neoliberal capitalism, public policy is a joint production of not
only government but also private foundations and lobbyists and think tanks and the private or
corporate financial interests those entities represent. There is not an AIC because of behaviorism;
there is an AIC because of neoliberal capitalism. And the problem is not the autism industries,
per se—autism couldn’t not have been commodified within this increasingly entrenched and
heavily enmeshed neoliberal form of economic/governmental organization. The underlying
problem is, was, and will continue to be neoliberal capitalism.
In closing their discussion of the American education industrial complex, Picciano and
Spring (2012) argue that “the threat to the American way of life is seeing our schools and our
children as markets from which to derive profits” (p. 177). In specific relation to the AIC, it is
not only our schools but our homes that have become markets for the autism industries, and our
(autistic) children are not markets but actually commodities, harvested for the generation of
profit. Their closing summary analysis is both dispassionate and incisive, and well worth
considering at some length, as a direct analogy to the autism industrial complex:

In summary, networks link the public purse to education [autism] businesses, trade associations, government policies, and
promoters of supporting ideologies from foundations and think tanks. Flexians move along the lines of this network as
taxpayers fill the public purse and trade associations for education [autism] businesses lobby for government money to be
spent on their members’ products. Education [Autism] businesses also directly lobby lawmakers. Foundations and think
tanks provide the justification to channel money from the public purse to educational [autism] profiteers. The student
[autistic person] is a captive in this economic and ideological network that we call the education[autism]-industrial
complex. (p. 173; bracketed text inserted)

Further, and critically, just as Picciano and Spring (2012) argue that “the media . . . has not
helped the public understand the implications of free market ideology applied to education or the
growth of the education business sector” (p. 172), so I argue here that the media has not helped
the public to understand the implications of “free market” neoliberal ideology applied to autism
or the growth of the autism business sector. Rather, the mainstream media—following the lead of
the corporate media giant Autism Speaks—have worked to actively groom the public’s
perception of autism (and therefore, of autistic people) from the standpoint and perspective of the
autism industries. In this case, media coverage has not helped to educate the public about autism
(nor autistic people); rather, it has been largely deployed to manufacture not only content about
autism, but also consent (Herman & Chomsky, 1988) to the logics of intervention and
prevention, and therefore, to participation in the autism industrial complex.
You might be an industry if public and media relations, branding, messaging, and media
content production are substantial investments in your ventures. You might be an industry if you
retain high-end lobbyists (sorry— “advocates”) and legal consultants to lobby either federal or
state governments for legislation or regulations that are hospitable to your ventures. You might
be an industry if you seek large infusions of capital from venture philanthropists, private
foundations, or government agencies to scale up your operations. You might be an industry if
your chief science officer comes from corporate Big Pharma, rather than from a research
university. You might be an industry if as many members of your board of directors come from
Wall Street as come from disability advocacy, education, or human service sectors. You might
be an industry if multiple high-powered players within that industry operate as flexians who can
trace their own professional pedigrees in and out of Wall Street, corporate media, service in
government agencies or on advisory boards, private philanthropic foundations, nonprofit
corporations, and venture capital firms. And you might be an industrial complex if the rhetorical
and conceptual apparatus underlying these economic relations has become hegemonic: dominant
enough to be “so embedded in common sense as to be taken for granted and not open to
question” (Harvey, 2007, p. 5). Of course autism represents a market ripe for the harvesting—
why would we do anything else?
 Thus endeth the assembly of the basic economic apparatus of the autism intervention and
prevention industries within the AIC: the nonprofit corporations, the legislative and regulatory
accomplishments, the private foundations, the government funding, the translational research
value chains, the speed dating with venture capitalists, and always, always, always, the
messaging, branding, public relations, and media content (consent) production. And thus
beginneth the indefinite extraction of profit from autism and autistic people in the ever-
proliferating and -diversifying autism industries. And if you can’t turn a profit on autism within
this neoliberal landscape, then I despair of you.

References
Adulting on the Spectrum (n.d.). Home. [Facebook page]. Facebook. Retrieved June 30, 2021 from
https://www.facebook.com/groups/adultingonthespectrum/?ref=pages_profile_groups_tab&source_id=75219157496
Albrecht, G. L. (1992). The disability business. SAGE.
Autism CARES Act of 2019, 42 USC §§ 280–284 (2019).
Autism Science Foundation (n.d.a). Board of directors. https://autismsciencefoundation.org/about-asf/board-of-directors/
Autism Science Foundation (n.d.b). Our mission. https://autismsciencefoundation.org/about-asf/our-mission/
Autism Science Foundation (n.d.c). What we fund. https://autismsciencefoundation.org/what-we-fund/
Autism Speaks (n.d.a). For the record. https://www.autismspeaks.org/Autism-Speaks-facts# vaccines
Autism Speaks (n.d.b). One page mission.
https://www.autismspeaks.org/sites/default/files/Autism%20Speaks%20Mission%20One%20Page%202020.pdf
Autism Speaks (2020a, February 10). Celebrating 15 years of progress, Autism Speaks unveils reimagined visual identity and
effort to make 2020 its “Year of Kindness.” Autism Speaks. https://www.autismspeaks.org/news/celebrating-15-years-
progress-autism-speaks-unveils-reimagined-visual-identity-and-effort-make
Autism Speaks (2020b, February 11). Introducing the new Autism Speaks! https://www.autismspeaks.org/blog/introducing-new-
autism-speaks
Bettelheim, B. (1967). The empty fortress: Infantile autism and the birth of the self. Free Press.
Broderick, A. A. (2010). Autism as enemy: Metaphor and cultural politics. In Z. Leonardo (Ed.), Handbook of cultural politics
and education (pp. 237–268). Sense Publishers. https://doi.org/10.1163/9789460911774
Broderick, A. A., & Ne’eman, A. (2008). Autism as metaphor: Narrative and counter-narrative. International Journal of Inclusive
Education, 12(5–6), 459–476. https://doi.org/10.1080/13603110802377490
Deer, B. (2020). The doctor who fooled the world: Science, deception, and the war on vaccines. Johns Hopkins University Press.
Diament, M. (2015, February 9). Autism Speaks alters position on vaccines. Disability Scoop.
https://www.disabilityscoop.com/2015/02/09/autism-speaks-vaccines/20040/
Earle, J. (Host). (2020, August 25). Three generations of autism advocates [Audio podcast episode]. In Road to Resilience. Mount
Sinai. https://www.mountsinai.org/about/newsroom/podcasts/road-resilience/three-generations-autism-advocates
Eyal, G., Hart, B., Onculer, E., Oren, N., & Rossi, N. (2010). The autism matrix. Polity.
Haack, S. (2012). Six signs of scientism. Logos and Episteme 3(1), 75–95. https://doi.org/10. 5840/logos-episteme20123151
Harvey, D. (2007). A brief history of neoliberalism. Oxford University Press.
Herman, E,. & Chomsky, N. (1988). Manufacturing consent: The political economy of the mass media. Pantheon Books.
Human Genome Project (n.d.). Timeline of events. https://www.genome.gov/human-genome- project/Timeline-of-Events
Kanner, L. (1943). Autistic disturbances of affective contact. Nervous Child, 2, 217–250.
Picciano, A. G., & Spring, J. (2012). The great American education-industrial complex (1st ed.). Routledge.
Regalado, A. (2019, November 8). The world’s first Gattaca baby tests are finally here. MIT Technology Review.
https://www.technologyreview.com/2019/11/08/132018/polygenic-score-ivf-embryo-dna-tests-genomic-prediction-gattaca/)
Ring, R. (n.d.) Home [LinkedIn page]. LinkedIn. Retrieved June 22, 2021 from https://www.linkedin.com/in/roberthring
Silverman, C. (2012). Understanding autism: Parents, doctors, and the history of a disorder. Princeton University Press.
Singh, J. (2016). Multiple autisms: Spectrums of advocacy and genomic science. University of Minnesota Press.
Thierry, L. (Dir.) (2006). Autism every day [Film]. Autism Speaks; Milestone Video; The October Group.
Wakefield, A. J., Murch, S. H., Anthony, A., Linnell, J., Casson, D. M., Malik, M., Berelowitz, A. P. Dhillon, Thomson, M. A.,
Harvey, P., Valentine, A., Davies, S. E., & Walker-Smith, J. A. (1998: RETRACTED). Ileal-lymphoid-nodular hyperplasia,
non-specific colitis, and pervasive developmental disorder in children. The Lancet 351(9103), 637–641.
https://doi.org/10.1016/S0140-6736(97)11096-0
Wedel, J. (2009). Shadow elite. Basic Books.
Zhang, S. (2020, December). The last children of Down syndrome: Prenatal testing is changing who gets born and who doesn’t.
This is just the beginning. The Atlantic. https://www.the atlantic.com/magazine/archive/2020/12/the-last-children-of-down-
syndrome/616928/
PART FOUR

Autism and Biocapital:

On Precarity and Futurity

P ART FOUR REFRAMES THIS history of the AIC as, ultimately, a project of biocapital: the ongoing
extraction and salvaging of value from the bodies of (in this case) autistic people. The notion
of biocapital enables us to understand the deep and inextricable relationship between cultural
politics and political economy. By framing the AIC as a project of biocapital, we are better able
to understand not only its historical emergence, but perhaps more importantly, its dynamic and
ongoing evolution and therefore the implications of its multiple and mutable potential future
manifestations, not all of which are dependent upon the future existence of autistic bodies (nor
therefore, autistic people). I turn, in the end, to the work of anthropologists: specifically, to Rajan
(2006) for his concept of biocapital to make sense of not only the history but the future of the
AIC, and to Tsing (2015, Tsing et al., 2017), who, through consideration of the material vestiges
of violent human histories, offers promising conceptual devices that enable the exploration,
imagining, and living of other, evasive, subversive, unruly, and ultimately (hopefully) livable
multiplicities of autistic futurities both with/in and with/out neoliberal biocapitalism.

References
Rajan, K. S. (2006). Biocapital: The constitution of postgenomic life. Duke University Press.
Tsing, A. L. (2015). The mushroom at the end of the world: On the possibility of life in capitalist ruins. Princeton University
Press. https://doi.org/10.1017/CBO9781107415324.004
Tsing, A., Swanson, H., Gan, E., & Bubandt, N. (Eds.) (2017). Arts of living on a damaged planet. University of Minnesota
Press.
CHAPTER NINE

Autism and Biocapitalist Emergences:

Biopolitical Technologies of Control

V ERY OFTEN, IN THE final sections of academic manuscripts, authors conclude their analyses
with nebulous calls to action that purport to be radical and transformative (i.e., urging
readers to “dismantle” or “deconstruct” oppressive institutional structures), but that ultimately,
more often than not, are unhelpful, ineffectual, and even grounded in fanciful thinking. Let me
be clear: in excavating this particular history, I am not suggesting that there is any simple,
straightforward, transformative, or revolutionary alternative to the AIC. I am not interested in
creating an alternative enemy. I am not trying to ban behaviorism (as others have suggested in
more activist spaces) (e.g., Sequenzia, 2016). I am not calling for revolution or for the systematic
dismantling of behaviorism, of capitalism, or indeed of anything. As a pure thought experiment,
entirely removing behaviorism from the mix still leaves: autism and capitalism. This, I argue, is
(and will continue to be) the crux of the matter. Indeed autism cannot be understood outside of
the context of capitalism because autism, as we know it, does not exist and has never existed
outside of capitalism itself. Autism, and indeed the Autism Industrial Complex, are
quintessential examples of neoliberal biocapitalism at work. And this premise best enables us to
understand not only the history, but also—and crucially—the future of the AIC.

Autism and Biocapital

Kaushik Sunder Rajan (2006), in his complex multisited anthropological ethnography,

Biocapital: The Constitution of Postgenomic Life, elegantly theorizes a synthesis of the
inextricable and ontologically binding tentacles of Foucauldian knowledge/power/cultural
politics (biopolitics) with a Marxist structural analysis of political economy, which he refers to in
corporate form as biocapital. In Rajan’s reading of Marx as “a methodologist from whom one
can learn to analyze rapidly emergent political economic and epistemic structures” (p. 7,
emphasis in original), he performs a complex analysis contending that “the life sciences and
capitalism are coproduced” (p. 6), just as I have argued that autism and capitalism co-constitute,
or coproduce, one another. The concept of biocapital enables us to understand not merely the
ways that autism and capitalism have co-occurred or coincided or coexisted with one another
over the past 75 years, but rather, the ways that they have epistemologically and ontologically
co-created one another. That is, according to Rajan, “what is crucial here is not just an
understanding of capitalisms (however multiple) as structures that form the grounds for the
emergence of a certain sort of technoscientific enterprise but also an understanding of political
economy as epistemology” (p. 11, emphases in original). That is, autism did not exist (and was
not “discovered”) as a static and objective ontological category that the structures of neoliberal
capitalism then commodified and extracted profit from; rather, neoliberal biocapitalism has
functioned as an epistemological (and, I argue, ontological) framework within which autism
was/is/(and will continue to be) (co)created, (co)manufactured, (co)produced, and importantly:
commodified and consumed.
Rajan states that he “read[s] Marx as himself only able to achieve a critique of capital by
means of critiquing political economy as the emergent foundational epistemology of the time”
(p. 11). According to Rajan, the core theoretical argument of his text is that “one can understand
emergent biotechnologies such as genomics only by simultaneously analyzing the market
frameworks within which they emerge,” and he further contends that, in doing so, “marketing
discourse, the hype and hope surrounding emergent technologies, the fetish of genetic
determinism, and the belief in science, nation, and religion all constitute the assemblages of
postgenomic life” (p. 33). Similarly, the AIC’s biopolitical technologies (such as ABA and
genomics) can only be understood by simultaneously analyzing the market frameworks within
which they have emerged. The AIC has forged multiple specific biotechnologies: these include
principally and most notably the biopolitical technologies of ABA intervention (which, to be
clear, were not invented as ideas or as practices for autism or for the AIC specifically, but rather
were developed and commodified as an industry of commercially available intervention products
in tandem with the cultivation and development of the AIC marketplace); however, they also
include a range of other biotechnological developments ranging from burgeoning
psychopharmacological treatments to wearable biosurveillance technologies and associated apps
designed to detect and disrupt impending “meltdowns” in autistic people (Arntsen, 2019; Egger
et al., 2018; McGuire, 2019). Most ominous, perhaps, is the basic genetic and genomic research
laying the groundwork for the potential future development of the ultimate biosurveillance
technology of the AIC: the ability to prenatally detect and, through screening, either disrupt or
prevent autism in human fetuses.
Many scholars have critically analyzed these biotechnologies as discrete sets of practices or
technologies on the grounds of their efficacy, their ethics, their feasibility, etc. However, as was
argued in Chapter One, few scholars have yet sought to understand these technologies by
simultaneously analyzing the market frameworks within which they emerge. I have conducted
this excavation of the AIC—as, ultimately, a project of biocapital—in pursuit of that very
analysis. Further, in so doing, my analysis of the AIC has treated the branding and marketing of
the biotechnologies of ABA, the attendant “fact production” (Rajan, 2006, p. 19) of science and
scientism, and the political economy of hope and of hype (e.g., recovery) surrounding these
biopolitical technologies of control as collectively comprising the assemblages of both autistic
and allistic life as disciplined within the ideological/rhetorical and economic/material
architecture of the AIC.
Rajan’s analysis builds upon Foucault’s foundational construct of biopolitics, which focused
specifically on the contention that power (more specifically, what Foucault termed “biopower”)
(Foucault, 1978) “operates through institutional, epistemic, and discursive mechanisms” (Rajan,
2006, p. 13, emphases in original). To Foucault’s analysis of biopower, Rajan adds Marx’s
analysis of capital, and it is these intertwined analyses that Rajan terms biocapital. Rajan makes
a compelling case for intertwining these analyses by arguing that “Foucault does explicitly” what
“Marx does implicitly,” which is to recognize the import of considering political economy not
merely because it is a foundational system of exchange, but rather because it functions as “a
foundational epistemology that allows us the very possibility of thinking about such a system as
a system of valuation” (p. 13, emphases in original). According to Rajan, the biopolitical, then,
 does not just refer to the ways in which politics impact everyday life, or in which debates over life (such as, to take an
evident example, over new reproductive technologies) impact politics, but rather points to the ways in which our very
ability to comprehend “life” and “economy” in their modernist guises is shaped by particular epistemologies that are
simultaneously enabled by, and in turn enable, particular forms of institutional structures. (pp. 13–14)

Indeed Rajan’s ethnographic analysis of genomics and biotechnologies is presented as “an

explicit attempt to bring together Foucault’s theorizations of the biopolitical with a Marxian
attention to political economy, labor, value, commodity forms, and processes of exchange as
they get constituted alongside the epistemic and technical emergences” of those very fields (p.
14). Beginning with Foucauldian theorizations of the biopolitical (which is where I started some
20 years ago when I embarked upon this analytic project), I will briefly map the extant analyses
of autism and biopolitics; then, taking a page from Rajan and treating Marx as methodologist,
layer attention to political economy over that analysis and the heuristic of the AIC, treating
emergent systems of biocapitalism as both epistemological and ontological frameworks
necessary to make meaning of the emergence and continuing existence of the AIC.

Autism and Biopolitical Technologies of Control

In 2017, Kenneth Saltman wrote a scathing indictment of public education in the United States as
increasingly engaging in repressive, controlling, and authoritarian tactics that he argued “cannot
be understood apart from the powerful economic forces driving [them]” (Saltman, 2017, p. 3).
He argued that “the crisis of overaccumulation has also driven disaster politics in which profit
accumulation strategies have been sought through destruction” and that public education “has
been positioned as ripe for pillage” (p. 3) by the private sector, seeking out new markets to
harvest and ultimately dispose of. And, Saltman correctly points out, “of course, all of this
repression in its pharmacological, technological, curricular, and pedagogical forms is big, big
business” (p. 5). He also correctly points out that the globalizing forces of neoliberal capitalism,
the ideological reach of mass corporate media, and the willingness of both the private and public
sectors to commodify youth in order to create new possibilities for profit extraction are all
necessary elements to the rise and perpetuation of the widespread deployment of these
biopolitical technologies of control under the guise of “education.”
However, it must be noted that all of the particular repressive tactics Saltman analyzes with
outrage and alarm are the stock-in-trade of what has long been considered appropriate, necessary,
and even excellent “pedagogy” or intervention for autistic students, since the very earliest days
of the AIC—and for many of these tactics, continuing today. For example, Saltman rightfully
protests the profitable industry pushing Ritalin and similar stimulant medications to treat the
socially constructed disability of attention deficit hyperactivity disorder (ADHD). However,
from the very genesis of autism as an ontological category, autistic people have been subjected to
psychotropic pharmacological interventions, and Saltman fails to mention this more egregious
history of autistic students being “treated” with vastly more invasive antipsychotic
pharmacologicals, long considered appropriate and effective treatment interventions for autism
(and apparently, if the investment scuttlebutt is to be believed, on the verge of scaling up to
include even more widespread use).
Similarly, while he rightfully protests the increasingly systematic deployment in schools of
behaviorist technologies (rewards, punishments, and token economies) to control students’
bodies (and, he argues correctly, their minds), Saltman fails to mention the vastly more egregious
set of behaviorist technologies commonly deployed against autistic students in the history of
“therapeutic” or “educational” autism intervention. These include, as has been discussed, the
withholding of food to induce a greater desire to comply with demands in order to be “rewarded”
with the provision of food, as well as the systematic deployment of contingent aversives
(punishments) such as slaps, the squirting of noxious fluids in the mouth or the eyes, and even
electric shock administered in response to autistic behavior (e.g., Gonnerman, 2007; Greenfeld,
1972; Lovaas et al., 1973). Of course, these latter are largely the behaviorist technologies of the
clinic, the laboratory, and the institution; upon increasing integration of autistic students into
mainstream public schools, these have been largely abandoned in favor of the subtler (although
still repressive) forms of behaviorist control that Saltman describes, in addition to the even-more-
egregious practices of physical restraint and seclusion in schools (see Roscigno, 2020), practices
that are disproportionately deployed against disabled and autistic students, and more particularly
against disabled and autistic students of color (Richards et al., 2019).
Saltman additionally decries the increasingly common deployment of surveillance
technologies, including biometric technologies, against students as tactics of control, as well as
increasingly corporatized curriculum and teacher preparation, both of which he argues deskill
and deprofessionalize teachers. Again, these are just and fair critiques of increasingly
authoritarian trends in tactics of schooling “nondisabled” students, and yet again, I cannot help
but wonder why Saltman’s outrage does not appear to extend to disabled and autistic students.
Just as Saltman’s analysis lacks a nuanced discussion of the role that institutionalized racism
plays in this corporatization of public education, so, too, does his analysis lack any discussion at
all of the role that institutionalized ableism has played in this particular (d)evolution. Autistic
children are among the most heavily surveilled, and their bodies the most tightly controlled, in
any public school. Many are literally under the 1:1 surveillance of a paraprofessional adult
employed solely to surveil and control (sorry—“support”) a single autistic student. I have
witnessed with abject horror the ostensible academic content of a 1:1 “lesson” in school be
completely jettisoned in favor of 20 minutes spent policing and dominating a child’s posture, eye
gaze, and even affect: “Hands down,” “feet on the floor,” “look at me,” “stand up,” “sit down,”
“hands on head” (the latter, as you may imagine, deployed solely to require the subaltern child to
demonstrate docility and abject submission to the controlling and domineering commands of the
adult, no matter how absurd or meaningless those commands may be, albeit allegedly merely
requiring the child to demonstrate “attention” and “readiness” to learn).
And it is additionally worth pointing out that, for 20 years now, the ABA industry has been
actively involved in the deprofessionalization and deskilling of teachers by replacing, for autistic
students, teachers (who might know something about math or about reading or about science)
with behavioral technicians who are professionally trained not as pedagogues nor as academic
content experts but as certified controllers of bodies through deployment of behaviorist
technologies. To be clear, my central intent is not to demonize the behaviorists or the private
consultancy firms trying to make a living in a capitalist economy. And indeed a majority of
behavioral technicians themselves are arguably generally well-intended people who strongly
believe they are acting in the best interests of their students when they consent to actively
participate in the deployment of these technologies (beliefs and consent that are carefully and
deliberately groomed, as we shall see shortly). The problem is not just that the ABA industry is
selling what it’s selling; the larger problem is that parents, teachers, and school districts of
autistic people are buying it. Indeed, public school districts and parents of autistic children are
eagerly and voraciously consuming these intervention services on a significant scale. And if
superintendents, directors of special education services, and building principals have been
willing to relegate some of their (autistic) students as not needing teachers after all, but rather,
behaviorists (or worse, “behavior technicians” whose baseline educational requirement is a high
school diploma) and have additionally been willing to appropriate public dollars to pay
exorbitantly high consultancy fees rather than invest in responsive curricula, pedagogies, and
professionals to meet those students’ educational needs, then it should perhaps not surprise
Saltman nor any of the rest of us if increasingly privatized, increasingly corporatized,
increasingly authoritarian technologies are working to expand their market share within a sector
that has proven itself to be ripe for the harvesting—that of ostensibly “public” (and by that, I
merely concede “publicly funded”) education.
Mitchell and Snyder’s (2015) The Biopolitics of Disability: Neoliberalism, Ablenationalism,
and Peripheral Embodiment synthesizes more than a decade of the authors’ scholarship on the
biopolitics of disability, departing from extant work on biopolitics in education (such as
Saltman’s) by centering their analysis on the experience and biopolitical tactics of disablement,
while simultaneously departing from the bulk of extant critical work on disability in education by
centering their analysis on the workings of biopolitics. Within neoliberalism, they argue,
disabled and other marginalized bodies are increasingly recast as “new commodification
opportunities” (p. 11), and they argue further that what they describe as “inclusionist techniques”
have “less to do with a more expansive tolerance toward formerly deviant citizens than the
appropriation of disability as an opportunity for expansion at the consumption end of late
capitalist marketplaces” (p. 11). And many of these repressive technologies (of control, of
surveillance) have been developed, beta-tested, and deployed on disabled bodies, often for
decades, in advance of their more widespread corporate deployment through mechanisms such as
those that Saltman eventually notices and decries when levied against predominantly nondisabed
bodies in public schools.
Mitchell and Synder’s scholarship on biopolitics additionally offers us the concept of
peripheral embodiment, a term designating what they call the “surplus humanity” occupying
“sites of interaction between fantasies of normative bodies and the disabled bodies that give life
to the fictionality of normativity” (p. 14). It is those occupying these peripheral embodiments,
who are not easily or readily appropriated or included into neoliberal mechanisms of
consumption, that are at greatest risk of themselves becoming commodified for the generation
and extraction of profit. These disposable and dispossessed people, in many cases, themselves
function as canaries in the proverbial coal mines, subject to increasingly authoritarian biopolitical
technologies and, ultimately, beta-testing the market. Snyder and Mitchell’s earlier work
(Snyder, 2002) documented the undoubtedly most egregious example of this history from the
mid-twentieth century: in their documentary film A World Without Bodies, they chronicle the
German Nazi Party’s meticulous and systematic testing—on disabled people—of the
mechanisms of killing people en masse in what was known as the T4 program, the technological
apparatus of which was subsequently scaled up to also facilitate the genocide of Jews,
homosexuals, ethnically Roma people, and others during the Holocaust. Just as the Nazis tested
and “perfected” the efficiencies of the technologies of genocide on the disposable, peripheral
embodiments of disabled people, so, too, have the authoritarian technologies of surveillance and
of control documented by Saltman and others been tested and perfected over the course of
decades on the bodies of autistic and other disabled people, in part through the mechanisms of
the AIC. And, as was the case in Germany in the 1930s, this enterprise has been conducted
largely without any wide-scale objection, protest, or resistance from nondisabled communities.
How is this possible?
 Roscigno (2019) has offered one of the most incisive and generative analyses to date of the
workings of the complex mechanisms of biopolitical technologies of control systematically
deployed against autistic people specifically. Roscigno contends that “ABA is a technology of
control that seeks to manage ‘unruly bodies’ (Erevelles, 2000, p. 25)” (2019, p. 2), and further,
that

[the] institution of ABA serves a biopolitical function in the Foucauldian sense—selecting a certain strata of society to
receive lifegiving resources, and removing provisions from others, echoing Foucault’s assertion that biopower is the
“power to ‘make’ live and ‘let’ die” (Foucault, 2003, p. 241). (p. 2)

However, her analysis goes well beyond a dissection of the biopolitical functions of ABA
technologies as exercised upon autistic bodies. She also deftly excavates the curious question of
consent: how is it that so many teachers, parents, clinicians, and other adults are, as Roscigno
puts it, “seduced . . . into the biopolitical project” (p. 1), even when that project may involve
subjecting a child to seclusion, restraint, and other dehumanizing forms of punishment?
Roscigno argues that behaviorism in general, and ABA in particular, “is a prevailing form of
what gender studies scholar Kyla Schuller (2017) terms biophilanthropy, a form of biopolitics in
which the technologies of control are rebranded as philanthropic ventures” (p. 1). Indeed she
contends that ABA is

particularly exemplary of biophilanthropy, [and that] a successful application of the science of behaviorism allows for the
recipient to be made includable in liberal capitalist society—and thus allows for any of the inherent violences contained
within to be considered necessary, a preferable alternative to social (or literal) death. (p. 4)

Thus the rhetorical, epistemological, and ontological labor engaged in within the biopolitical
regime of ABA involves not merely the dehumanizing extraction of value from those who
materially experience peripheral embodiments (Mitchell & Snyder, 2015) within the
epistemological framework of neoliberal capitalism, but also the simultaneous and symbiotic
labor of humanizing the nondisabled teacher/therapist/clinician as a means of grooming their
consent to active participation in what is cast as necessary, benevolent, and even salvationary
(albeit often violent) labor on their part. I argue that this gaslighting process of grooming the
active participation and consent of parents, teachers, and other clinicians in enacting these
repressive forms of domination (cast as “benevolent”) upon autistic people is a necessary
economic investment in the functioning of the autism (or educational, psychiatric, prison, etc.)
industrial complex(es). People participate in these repressive technologies in no small part
because they accept the pervasive cultural narrative that such interventions are “right,”
“necessary,” “scientific,” “good,” “just,” and even a “human right” that they have the ability and
therefore the obligation to provide.
Disrupting this participation can be difficult because recognizing and subsequently
acknowledging that these narrative justifications may be false may create psychological
dissonance and alienation (for the clinician). Therefore, for many, doubling down on the
narrative is the path of least resistance, and one’s belief in and commitment to such intervention
technologies begins to take on the tenor, discourse, and even fervor of a religion or a cult. I am
not falsely equating the repression of those subjected to such interventions with the repression of
those groomed into actively subjecting others to them; merely articulating that rhetorical and
narrative technologies of control pervade the entirety of the industrial complex and the
relationships and subjectivities forged within it. Indeed, I concur with Roscigno (2019), who
cautions us to “resist reifying a binary between teacher and student,” reminding us that “within a
biophilanthropic regime, both teacher and student are disciplined and surveilled” (p. 6) and that,
further, “the redemptive capacity of the enterprise is bestowed upon those who are doing the
redeeming” (p. 8). Through a detailed archival analysis of a behaviorist study of the impact of
punishment (upon both subject and clinician), Roscigno illuminates the evident premise that “the
participation of the teacher is necessary and their buy-in is carefully considered,” contending
that, “by constructing the autistic body as a threat to national futures, those responsible are
absolved on [sic] their guilt and their abuses are reconstructed as an act of service. This is
necessary to seduce the teacher into administering punishments” (p. 8).
Considering the technologies of ABA collectively as a suite of biopolitical technologies of
control (as Roscigno and others have convincingly argued) would seem to require at least a brief
revisiting of the question of the ethics of ABA intervention in general. Recall the analysis of
ethicists Wilkenfeld and McCarthy (2020), discussed in Chapter Five, who charged that ABA
intervention for young autistic children “manifests systematic violations of the fundamental
tenets of bioethics,” and that “employing ABA violates the principles of justice and
nonmaleficence and, most critically, infringes on the autonomy of children and (when pushed
aggressively) of parents as well” (p. 31). These ethicists acknowledge that these very charges
have long been advanced by autistic people, to little avail, in part because they tend to be
countered (mostly by nonautistic people) with systematic counter-claims that skillfully deploy
the rhetorics of scientism, efficacy, evidence-based treatments, and—perhaps the most Orwellian
of all—rights-based discourses in service of the biocapitalist project.
According to Roscigno (2019), within neoliberal, rights-based discourses of evidence-based
treatments, “the child has a right to restrictive intervention, like punishment and the use of
aversives” (p. 9). Puar (2017) argues that rights-based discourses “discriminate which bodies are
vested with futurity, or more accurately, they cultivate (some/certain) bodies that can be vested
with futurity” (p. 15). Yet it is not merely that the culturally privileged invoke rights-based
discourses to gain subsidized access to expensive interventions, nor that the history of rights
discourses within the disability rights movement has been saturated in White privilege to
cultivate the futurity of the autistic toddlers of White and wealthy parents; it is, rather, more
insidious than that. The propagation of rights-based discourses is increasingly deployed as a
strategy of market expansion: targeting “underserved” communities to groom within them the
gaslit belief that they should fight for their child’s “right” to debilitating interventions, cloaked in
the entitlement to “equal” treatment and in the hope of a potential capacitated future (which
structural racism and income inequality will ensure is unlikely to eventuate). Thus the limiting
rhetorics of neoliberal rights-based discourses function to produce what Roscigno calls “a
proverbial Ouroboros—a serpent eating its tail; the impetus to construct includable bodies
(Mitchell & Snyder, 2015, p.14) produces violence through the very intervention designed to
abate it” (p. 2).
Which is, of course, the point. Whether the child is ever capacitated to the status of
“includability” or not, that child (commodity) has served their function—debilitation is in fact a
“biopolitical [and biocapitalist] end” unto itself (Puar, 2017, p. xviii, bracketed text added).
Within this almost Orwellian rhetorical landscape, questions of harm, beneficence, and human
rights become murky, counterintuitive, oxymoronic, gaslighting. If people who participate in
providing or administering the repressive biopolitical tactics of corporatized autism intervention
do so in part because they are actively groomed into a conceptual apparatus that positions such
interventions as right, necessary, scientific, good, and just, so, too, are many parents groomed
into a conceptual apparatus within which they demand these “services” as not only necessary,
scientific, and good, but also as a right—and, therefore, to be claimed and fought for. The
dissonance between these rhetorics—of beneficence and civil and human rights and even
emancipation—and the abject materiality of the subaltern and dehumanizing ways that many
autistic people experience ABA intervention yields for many a profound sense of alienation or
even dissociation. And some characterize the systematic subjection to biopolitical technologies
of control such as ABA interventions as traumatizing.
Trauma does not result merely from experiences of extreme pain or abject fear; trauma is
resultant of those kinds of experiences coupled with a complete sense of powerlessness, a
complete absence or loss of control, sometimes at the hands of a dominating other. Stand up. Sit
down. Touch head. Hands down. Look at me. Kupferstein (2018) presents preliminary
testimonial evidence of increased posttraumatic stress symptoms (PTSS) (many meeting criteria
for posttraumatic stress disorder [PTSD]) among autistics exposed to intensive ABA
interventions. According to Kupferstein, findings of her preliminary survey “noted PTSS in
nearly half of ABA-exposed participants, while nonexposed controls had a 72 percent chance of
being asymptomatic,” (p. 19). Further, Kupferstein reports that

nearly half (46 percent) of the ABA-exposed respondents met the diagnostic threshold for PTSD, and extreme levels of
severity were recorded in 47 percent of the affected subgroup. Respondents of all ages who were exposed to ABA were
86 percent more likely to meet the PTSD criteria than respondents who were not exposed to ABA. (p. 19)

Kupferstein’s report on the findings of this exploratory survey design were immediately and
roundly (and justifiably) critiqued on methodological grounds (Leaf et al., 2018), contending that
“Kupferstein’s results should be viewed with extreme caution due to several methodological and
conceptual flaws including, but not limited to, leading questions used within a nonvalidated
survey, failure to confirm diagnosis, and incomplete description of interventions” (Leaf et al.,
2018, p. 122). However, this publication and its response are nevertheless worthy of critical
analysis as an example of the discursive deployments that circulate within a biocapitalist industry
in which information functions as symbolic and reputational capital. According to Leaf et al.’s
(2018) critique of Kupferstein’s study, “perhaps the most concerning possibility resulting from
[her analysis] is the potential for families to avoid seeking out and receiving what has been
documented as the largest category of established interventions for individuals diagnosed with
ASD” (p. 127), and further, that the “dramatic and startling claims made within Kupferstein’s
study could create the premise to deny families effective intervention and/or turn families away
from obtaining ABA-based interventions” (p. 127). Thus, it would ostensibly violate the rights of
families of autistic children to “deny” them access to “effective,” “documented,” and
“established” interventions such as ABA, and the Ouroboros once again rears its ugly head
(tail?).
However, as the authors of a rejoinder to that critique (Chown et al., 2019) pointedly remind
readers of the publishing journal in a letter to the editor, Leaf et al.’s (2018) response to
Kupferstein was “funded by the Autism Special Interest Group [of the Association for Behavior
Analysis International] […] and an anonymous donor who supports ABA-based interventions for
individuals diagnosed with autism” (p. 318), and any critiques of Kupferstein’s study must be
read within the context of the disclosure of this financial conflict of interest of her critics. Recall
that the ABAI is one of two professional organizations that the BACB encourages its members to
join, one that it identifies as being able (unlike itself, with the legal constraints of a nonprofit) to
act in favor of specific policy and even political interests. Nonetheless, the critique of
Kupferstein’s original publication can be regarded as an example of what may happen when
unaffiliated scholars (or activists) challenge the party line of a well-funded intervention industry.
More recently, Sandoval-Norton and Shkedy (2019) have published a position paper titled,
“How Much Compliance Is Too Much Compliance: Is Long-Term ABA Therapy Abuse?” The
authors, who are the clinical director and director of research, respectively, of the San Diego-
based nonprofit organization Alternative Teaching Strategy Center (ATSC) state that they
received no direct funding and declare no conflicts of interest in the production of this
manuscript. However, it seems fairly evident and should be acknowledged that their nonprofit
organization by definition either directly or indirectly competes with the ABA industry for
clients in the intervention marketplace. That said, their critique of the ABA industry
(specifically, their charge that prolonged exposure to intensive ABA intervention for
nonspeaking autistic children is tantamount to abuse) is more cogent than many others, in part
due to their explicit acknowledgment of the scale of the economics at stake in the largely for-
profit ABA intervention industry. According to the authors,

In 2017, one investment firm estimated that the market size for ABA services could be as high as $17 billion annually,
and with the continued creation of various ABA specialists, certifications, and programs that number is likely even greater
now (Crocker Capital Advisors, 2017). With this kind of information is it [sic] evident what drives the continued use of
these services. (p. 5)

The authors further contend that

As research continues to find negative impacts on children and adults who have been subjected to years of ABA
interventions, psychologists need to ask themselves whether or not this archaic approach to treating ASD is in line with
their oath to do no harm. (p. 5)

Not surprisingly, throughout the manuscript, the authors offer their own response to this
rhetorical question, the answer to which is a resounding assertion that no, it is not in line with
that oath. Descriptors used throughout the manuscript in describing prolonged ABA
interventions with nonspeaking autistic people include “undoubtedly abusive” and “frankly
irresponsible” (p. 4), coupled with assertions throughout that such practice risks inducing
“physiological pain,” “emotional and psychological harm,” and “psychological and physical
abuse” (p. 4). Among the more incisive of the authors’ observations is the charge that “this
approach to treating typical clients would never pass” (p. 5), specifically in relation to the
recommendation to employ admittedly anxiety-provoking interventions with people already
likely to experience heightened physiological anxiety.
Again, a sense of rhetorical incredulity is detected in the tone—this approach to “treatment”
would never be countenanced for clients considered to be “typical.” Recall Saltman’s (2017)
outrage at biopolitical technologies of corporate power and control being levied against
(primarily nondisabed) students in public schools (the same technologies that have been
systematically levied against autistic and other disabled people in the clinic, the institution, and
even the school for decades, prompting little if any outrage on the part of critical educators such
as Saltman). Ethics and rights-based discourses have morphed into Orwellian forms of
doublespeak, skillfully deployed to justify (and create a desire for) the very violences those
discourses might once have been used to rail against. And I’ll argue that neither science (e.g.,
calls for replication) nor ethics (e.g., calls to evaluate one’s practice in relation to an oath to do
no harm) are adequate frameworks for understanding, let alone responding to, the widespread
ideological and epistemological monopoly of the AIC. Capitalism is ontologically hegemonic: it
is not merely the dominant logic undergirding the AIC, it is the dominant logic within which
both science and ethics are conceptualized and practiced, and to invoke either discourse without
excavation of its own positioning within capitalism will yield partial and inadequate
understandings at best.
More complex theorization is required of this analysis; more fluid, nuanced, and destabilizing
sets of ideas, what queer theorist Jasbir Puar (2017) calls “interrogating the place of language
itself” (p. 27) in her seismic text, The Right to Maim: Debility, Capacity, Disability. Drawing
upon posthumanist ideas, Puar writes,

In so doing, language can enter multiplicity, and it can also be resituated as . . . one platform out of many through which
politics can enunciate, and finally one kind of matter. Language is not opposed to matter, but rather is matter—among
many matters (p. 27)

Puar further calls “biopolitics deployed through its neoliberal guises . . . a capacitation machine”
and incisively indicts biopolitics as “seek[ing] capacitation for some as a liberal rationale (in
some cases) or foil for the debilitation of many others,” essentially arguing that biopolitics is “an
ableist mechanism that debilitates” (p. xviii). Puar argues that debilitation is a biopolitical end in
and of itself, though I argue that both debilitation and capacitation, within capitalism, function as
means to the economic end of profit extraction. Puar calls this “the right to maim,” and contends
that “maiming is a source of value extraction from populations that would otherwise be
disposable” (p. xviii). Puar’s analysis is consistent with Mitchell and Snyder’s (2015) discussion
of “ablenationalism” (pp. 12–14), wherein they contend that, within neoliberalism, disability is
appropriated as “an opportunity for expansion at the consumption end of late capitalist
marketplaces” (p. 11). Thus, the traumatization experienced by autistic people systematically
subjected to ABA intervention can be understood, grammatically enunciated, made to matter, as
a form of maiming: an institutionally countenanced means of extracting value from dispossessed
(and apparently disposable?) autistic people.
Both Mitchell and Snyder’s (2015) theorization around ablenationalism and Puar’s (2017)
theorization of debility and capacity incisively (and finally) offer tools that critical autism
studies, and disability studies in general, has long been lacking—tools that enable the imperative
to more complexly theorize autism (and disablement in general) through the hegemonic
epistemological and ontological lens of neoliberal capitalism. As both discourse and
epistemology, “science” has failed to disrupt the hegemonic institutionalization of the AIC—and,
indeed, has actually been deployed to advance it. Likewise, as both discourse and epistemology,
“ethics” has also proven inadequate to disrupt the AIC and, when deployed in tandem with the
discourse and epistemology of individual rights and legal frameworks, has similarly been
deployed to advance it (for a cogent analysis of the deployment of the “right” to violent
interventions, such as restraint and seclusion, see Roscigno, 2020). Critically analyzing biopower
itself is inadequate if we do not also analyze the epistemological and ontological framework that
enabled its genesis, its ubiquity, and its hegemonic institutionalization—the epistemological and
ontological framework of capital.
Recall Rajan’s (2006) contention that Marx himself was “only able to achieve a critique of
capital by means of critiquing political economy as the emergent foundational epistemology of
the time” (p. 11). Indeed Rajan argues further that “one can understand emergent biotechnologies
such as genomics only by simultaneously analyzing the market frameworks within which they
emerge” (p. 33). Likewise, I argue that a cogent critique of the AIC can only be arrived at
through explicit engagement with neoliberal capitalism as its foundational epistemology, and that
understanding the complex assemblages of autistic (and allistic) life within the apparatus of the
AIC requires relentless critical analysis of the market frameworks within which the materialist
rhetorics of the AIC emerged and continue to be sustained. This reading of Marx as
methodologist thus enables the generative analytic framework of biocapital.
Why does the AIC exist? Because it can. Because within the foundational epistemology (and
ontology) of neoliberal capitalism, it can’t not. If there exists potential to imagine the extraction
of capital, that capital will be extracted. The technologies necessary to facilitate that extraction
will be developed because the capacity to imagine the extraction of that future capital exists. The
underlying, invisible, insidious, and monopolizing cultural logic undergirding the AIC and
facilitating its expansion and exportation globally is neoliberal capitalism. It has always been
capitalism. For the foreseeable future, it will continue to be capitalism. The rest—science, ethics,
rights- and evidence-based discourses, etc.—is rhetoric (which is not to say “mere” rhetoric, but
rather necessary, integral, devastatingly material, indeed existential rhetoric): branding,
marketing, consent-grooming, policy-shaping, legitimacy-manufacturing, subject-producing, and
reality-constituting rhetoric.
Rajan (2006), borrowing from Althusser, argues that the life sciences are “overdetermined by
the capitalist political economic structures within which they emerge,” thus suggesting a
“contextual relationship, but not a causal one (Althusser, 1969 [1965])” (p. 6, emphases in
original). He further argues that Marx emphasized what he calls the “tendential nature” (p. 7,
emphasis in original) of capitalist processes, and so speaks not of capitalism being determinant in
a structural sense, but rather speaks of political economic contexts as tending to lead to particular
“epistemic emergences” (p. 6). Thus when I argue that the AIC couldn’t not have developed, I
don’t mean to imply that the specific details as emerged were somehow determined in a
structural or direct causal sense, but rather that some iteration of an AIC couldn’t not have
developed within the overarching epistemological and ontological framework of neoliberal
capitalism. I argue further that the specific details of its particular epistemic emergence were
contextualized within surrounding historical, epistemological, and ontological contexts (e.g., the
emergence of autism as an ontological category, the ascendance of behaviorism as an ideology,
and later the ascendance of genetics in wake of the Human Genome Project, itself shaped by
neoliberal capitalism, and the ascendance and evolving entrenchment of neoliberal capitalism[s]
throughout the period of time analyzed), because as Rajan reminds us, “capitalism is in itself
dynamic, changing, and at stake,” and further, that it is “mutable and multiple; it is always
capitalisms” (p. 7, emphasis in original). In that sense, capitalism is not unlike life itself—it
exists because it can; it mutates and diversifies to fill and exploit every available ecological
(economic) niche, and as long as resources exist for it to consume, it will consume them. In the
life sciences, the purpose of life is life—reproduction. The purpose of capitalism is the
accumulation of capital, by whatever means are available or can be created. And capitalism, like
life, is tenacious. Next, building upon Rajan’s analysis, I trace the particular biocapitalist
emergences of the AIC by overlaying several elements of that analysis upon the key elements of
the AIC as analyzed thus far.

The AIC and Biocapitalist Emergences

Rajan argues that the sorts of knowledge that are emergent from the particular contextual
relationships between capitalisms and the life sciences allow us “to grammatically conceive of
life in certain ways” (p. 14, emphasis in original). Similarly, I argue that the sorts of biocapitalist
knowledge (and realities) that are emergent within the AIC orient us to conceive of autistic life in
certain ways and, further, make it nearly impossible to grammatically conceive of autistic life
outside of those frameworks. The AIC’s particular political economy of hope was explored in
detail in Chapters Four and Five, and within that emergent biocapitalist epistemological and
ontological framework, it is difficult—grammatically—to conceive of autistic life within
different frameworks and metrics of valuation. Rajan’s analysis is deeply textured and is both
complexly theorized and richly illustrated with empirical ethnographic data. I have culled here
several elements of that analysis that I use as conceptual frames that enable us to understand my
preceding analyses of elements of the AIC as biocapitalist emergences. These include an
exploration of the central organizing concept of value itself, the ways that subjectivities are
formed through biocapitalist mechanisms, the centrality of futurity as a concept for calculating
risk and potential for profit, and the extent to which these mechanisms are undergirded by
salvationary rhetorics and discourses (Rajan, 2006). Each of these has tendential implications for
the forging of autistic identities and subjectivities, which will be explored in the final chapter.
The notion of value is complex, fluid, contingent, and collectively forged. And yet this
concept is the fulcrum around which economic and financial activities hinge and coalesce. There
is nothing inherently valuable about gold, apart from its having been a shiny, pretty rock that was
aesthetically appealing to our progenitors who first picked it up and the fact that most of it turned
out to be underground, and therefore obtaining large quantities of it was a difficult (and
prohibitively expensive) process, which neatly ensured that not everyone who wanted some
could go out and just pick it up (the California Gold Rush notwithstanding). Its valuing (and
cyclically, devaluing) has been a collective, social, cultural process. And while in the beginning
its value may have hinged upon the basic concept of commodity scarcity, the emergence of
Bitcoin and other cryptocurrencies without material referents illustrates the ways that speculative
capitalism enables a notion of valuing that is potentially decoupled from any materiality and that
is also inextricably bound up in the concept of futurity. Rajan asserts:

The circulation of capital is intimately tied to questions of value. Value is one of those nice double-jointed words that
always already imply two different things. On the one hand, “value” implies the market value that gets realized through
processes of exchange. On the other, it implies the nonmarket values that might be called . . . ethics. (p. 41)

It is the question of where value resides, particularly in respect to information as capital, that
helps us to understand the AIC as a project of biocapital. It is necessary—informationally,
grammatically, ontologically—to devalue autism and autistic experience in order to successfully
achieve its inverse correlate: the valuing of intervention products and services that purport to
mitigate, lessen, “recover” from, or even prevent the culturally devalued experience of autism.
Hence the limitations of either ethics or science alone as primary frameworks for this analysis—
both are integrally intertwined and indeed implicated with/in the overarching biocapitalist
framework of market value. Value is created (and deflated) through the deployment of each of
these registers within biocapitalism. But if autism as an ontological category is susceptible to
commodification, surely (hopefully?) it must also be susceptible to decommodification (Rajan,
2006, p. 42).
Rajan (2006) contends that “information potentially has, in addition to Marxian use value and
exchange value, a third form of value, a ‘moral’ value that operates in the realm of symbolic
capital” (p. 56). When dealing in informational currency (recall that the preponderance of the
AIC’s architecture is rhetorical, discursive, ideological, and informational; the economic activity
is buttressed by these much more foundational activities and structures), the value of this
symbolic capital becomes immeasurable. Without the foundational valuing of this symbolic
capital (or were that symbolic capital to be significantly devalued), the floor of the AIC
marketplace may risk a precipitous drop in its economic value. Rajan lays bare the centrality of
the value of symbolic capital, arguing that “it is evident that the production of biocapitalist value
is to a large extent a discursive act, whether it is through advertising, the selling of futures, [or]
the rhetorical creation of a corporate scientific community committed to” (p. 57), in this case,
intervention for or prevention of autism. He argues that “it is evident, also, that information has
to perform active work, variously material and discursive, in the process of which” the (in this
case) autism intervention and prevention industries are “created as an ethical entity” (p. 57,
emphasis in original). It is the work of the industrial complex not only to devalue autism and to
commodify autistic bodies, but also and simultaneously to imbue both the work of the
interventionist technicians (as individual subjects) and also the intervention and prevention
industries themselves (as corporate subjects) with symbolic, ethical value. Thus the discursive
and rhetorical acts of devaluing and demonizing autism and of naturalizing, legitimizing, and
indeed valorizing intervention and prevention in relation to autism are fundamentally
biocapitalist projects of both the valuation and devaluation of symbolic capital.
However, value, like power, circulates. By “devaluing” and demonizing autism culturally,
rhetorically, and discursively through public relations and propaganda campaigns, this discursive
labor actually imbues autistic bodies with potential value for future extraction through the
production of indebtedness, as was discussed at length in Chapter One. Rajan (2006), in
agreement with Wang (2018), reminds us that “indebtedness is itself a form of valuation of
circulatory systems of exchange” (p. 76). It is this “biopolitics of indebtedness as constituted by
global circuits of biocapital” (p. 76) that we see operating in the AIC. Rajan explores in rich
detail the mechanisms of “alienation, expropriation, and divestiture” (p. 34) that are necessary
within biocapitalism to extract value from indebtedness as an organizing construct.
Within the AIC, autistic people are constructed as infinitely indebted and, therefore, as a
commodity with nearly infinite possibilities for value extraction. This process requires (as we
have seen illustrated) that autistic people experience the violence of the repeated imposition (by
the AIC) of the alienation of oneself from one’s autism (as if autism were not integral to one’s
self) and also from one’s fellow human beings. Being autistic is arguably not in and of itself an
alienating experience; however, being subjected to the onslaught of the literally alien-ating
violence of the AIC is chronically stress-inducing and a potentially traumatizing experience (e.g.,
repeatedly being rhetorically constituted either as an alien to the rest of humanity or as a latent,
dissociated normate self with a dangerous and “foreign” alien somehow lurking within one’s
own neurology and even consciousness will logically induce the experience of alienation for
many people).
This deliberate rhetorical tactic of subjecting autistic people to chronic discursive and
rhetorical alienation is a prerequisite tool for the subsequent expropriation of value from their
bodies through the intervention industry itself. There was a time when expropriation implied the
extraction of privately held value by and for the state; however, as the distinction between state
and private entities becomes increasingly blurred within neoliberalism, and as the state becomes
an increasingly corporatized entity, we can understand here the extraction of privately held value
to literally be the value that resides in the actual body of the individual autistic person—the latent
potential of that single, 2-year-old autistic child to set in motion a chain of biocapitalist value
extraction through diagnosis, referral for services, consultations, interventions, therapies, etc.,
that circulates not necessarily to the state, but very often through the state and sometimes on
behalf of the state (in the case of public education driving the intervention transactions, or
Medicaid dollars funding ABA intervention services) and thenceforth to private entities that will
ultimately glean the profits. The state, in many cases (and private insurance companies, in many
others), primarily provides the source of the funding (public tax dollars) that ends up on the
balance sheets of for-profit entities, thus both harvesting public monies for private profit, as well
as financially shoring up the bureaucratic state as its own arm of the industrial complex (e.g., by
the public employment of BCBAs, RBTs, other therapists, etc.).
And lastly, these mechanisms of alienation and expropriation are intertwined also with the
simultaneous mechanism of economic divestiture from autistic people (although in this case I
will argue it is more a failure to invest at all, rather than an active divestiture—one needs to have
previously invested in order to divest). There are some who will protest at this juncture, and
gasp, and say, “How can you claim divestiture when there are billions of dollars a year being
invested in therapeutic interventions and basic research, all for the benefit of autistic people?” To
that argument I would rejoin that these alleged “investments” are by and large not investments
in, nor the direction of capital toward, autistic people: they are, rather, symbolic investments in
normativity and in the speculative futures market of trying to produce nonautistic (or less-
autistic) people out of autistic people (who are themselves the commodity—the raw material—in
this process), or (and?) alternatively, working to create a world wherein fewer autistic people
may be born in the first place. They are also fundamentally, of course, investments of capital in
expectation of a future return on that investment—evidence of the “profitability of debility”
(Puar, 2017, p. 13), which are not investments in autistic people.
Similarly, it is difficult to argue investiture in autistic children’s education when the adult
with whom many autistic children spend the preponderance of their hours in school interacting is
a paraprofessional behavior technician, themselves the least educated and most minimally
professionally prepared adult in the classroom. These technicians may be very caring and kind
and well-intended humans; however, they have little to no education or professional preparation
in child development, pedagogy, or content areas (e.g., mathematics, science, literacy and
literature, the social sciences, etc.). There are, of course, better-educated and much more highly
compensated people supervising and overseeing that RBT’s daily activities (the AIC is
abundantly generative, after all), but it is difficult to imagine most nondisabed parents of
nondisabled students consenting to their child’s teacher serving in a merely supervisory role,
while classroom paraprofessionals with little to no education or professional preparation in child
development, pedagogy, or academic content constitute the preponderance of adult interactions
with their child on a daily basis (supervised, of course, by much more highly educated and
better-paid people who also generally have little knowledge of child development, pedagogy, or
academic content).
Rajan (2006) argues that all biotechnology “is a game that is constantly played in the future
in order to generate the present that enables the future” (p. 34). I earlier contended that the AIC
exists, in part, because the capacity exists to imagine the extraction of future capital from autistic
people as commodities. The AIC is deeply embedded in questions of futurity: the interventionist
arm of the AIC, in the capacity to imagine a future “recovered” autistic person, and the
preventionist arm of the AIC, in the capacity to imagine a world in which autism no longer exists
(which is, of course, the capacity to imagine a world in which autistic people no longer exist).
And as is the case with all speculative forms of capitalism, one has to be invested in a powerful
narrative expectation of an excellent, if not spectacular future return in order to invest. Rajan
describes how his analysis

trace[s] the conjuration of corporate promissory futures as a constitutive feature of biocapital, which changes the very
 grammar through which “life,” which now gets transformed into a calculable market unit, is understood, and which
structures the strategic terrain on which biotech companies [or interventionist companies] operate. (p. 34, bracketed text
added)

It is the promissory futures note of a “recovered” child that entices parents and school districts to
sign on the dotted line, with some families literally bankrupting their personal finances in order
to access this bio-political/-technological/-capitalist intervention for their children. And in
relation to this potential future promise is the figuration of risk, which as Rajan points out,
always involves consideration of the “operation of scientific facts, which themselves are
produced on terrains overdetermined by . . . vision and hype” (pp. 34–35).
A final element of Rajan’s analysis I will bring to bear upon my analysis of the AIC is his
discussion of the ways in which “the promises of biocapital are undergirded by salvationary and
nationalist rhetorics and discourses,” which he alternately describes as “promissory salvationary
science” (p. 35). The very notion of “recovery” from autism is swathed in salvationary and
redemptive rhetoric, and there can be little doubt that such rhetoric was deliberatively and
strategically and masterfully deployed, as described, in Lovaas’s (1987) rebranding of ABA
intervention. Recall once again that Lovaas’s rebranding manuscript (sorry—treatment effect
study) closed by explicitly invoking an economic cost/benefit analysis: “The assignment of one
full-time special-education teacher for 2 years would cost an estimated $40,000, in contrast to the
nearly $2 million incurred (in direct costs alone) by each client requiring life-long
institutionalization” (p. 9). The promissory note offered the implied hope of “recovery” from
autism, while the risk calculation included also the explicit spectral fear of “life-long
institutionalization,” wrapped in the redemptive rhetoric of salvationary science, itself, as Rajan
reminds us, “overdetermined by . . . vision and hype” as much as by the political economy of
hope. Likewise, Suzanne Wright’s vision of a future in which “autism is a word in the history
books,” and her promissory note that by funding Autism Speaks, we’d get there in her lifetime
(we did not). Be careful what you wish for. The AIC can only be understood through critical
analysis of the market frameworks within which it emerged. And “marketing discourse, the hype
and hope surrounding emergent technologies, the fetish of . . . determinism, and the belief in
science, nation, and religion all constitute the assemblages of” life within the apparatus of the
AIC (Rajan, 2006, p. 33): a quintessential example of a neoliberal biocapitalist project.

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CHAPTER TEN

On Being Autistic in Neoliberal Capitalist

Ruins:
Endemic Precarity and Autistic Futurity

R AJAN’S (2006) CONCEPT OF biocapital enables us to make sense of not only the history but,
perhaps as importantly, the future of the AIC. A central issue explored in closing is the
question of futurity, as it relates to autism, to autistic people, and to the AIC. Within the
biocapitalist project of the AIC, the question of futurity is quite literally existential (for autistic
people), but the potential for indefinite future profit extraction from autism (as commodified
ontological category) is boundless and is not, in fact, necessarily dependent upon the continued
existence of autistic bodies to commodify and from which to extract capital. Indeed, within the
AIC the indefinite extraction of profit from the commodity of autism may eventually rest not
upon autistic bodies at all, but rather upon the continued manufacture and widespread
consumption of the spectral fear of the potential future existence of autistic bodies in
combination with successful attainment of the biocapitalist holy grail of the AIC: the
biotechnological development and universal deployment of prenatal testing for autism.

Biocapitalism and Futurity

The concept of futurity is central to neoliberal biocapitalism. Rajan (2006) argues that

The sorts of knowledge genomics provides allows us to grammatically conceive of life in certain ways . . . as that whose
futures we can calculate in terms of probabilities of certain disease events happening—and this shifting grammar of life,
toward a future tense, is consequential not just to our understanding of what “life” now means, but contains within it a
deep ethical valence, what Nikolas Rose and Carlos Novas (2005) refer to as a “political economy of hope.” (p. 14,
emphasis in original)

Further, Rajan contends that the speculative nature of biocapitalism and its future-oriented
grammar “pertains to what might, in parallel to Rose and Novas, be called a political economy of
hype” (p. 14), and elegantly restates, “In other words, the articulations of life, labor, and
language are themselves in formation (and information) that constitute biocapital and
postgenomic life” (p. 14). If autism is successfully cast as a “disease event”—and we have seen
that substantial resources have already been invested, over the course of decades, in doing just
that—then this positioning in articulation with the economic apparatus of the AIC (see Chapters
Seven and Eight) circulates capital in pursuit of its aims and its activities in ways that
fundamentally rest upon a future-oriented organizing grammar. This grammar of futurity has
been central to the AIC from its inception, and the political economies of both hope and of hype
within it have already been discussed at some length. Moreover, the exploration of futurity as an
organizing grammar enables not only a complex understanding of where we are (and how we got
here), but also a potent (because anarchic) means of conceptualizing where we might go from
here. However, before exploring the future of the AIC itself, I first consider the impact of the
AIC’s biocapitalist future-oriented grammars and logics upon autistic identity.

Futurity and Identity

I argued at the outset of this text that the AIC has three primary products: the first and central
product being the ontological category of autism itself, the commodification of which
simultaneously commodifies autistic bodies. The second set of integrally intertwined products
that the AIC manufactures for widespread consumption are the normative and narrative cultural
logics of intervention and prevention. These products, as discussed, can be understood as
resultant of the AIC’s production processes of manufacturing symbolic biocapital (and therefore
value) through variously rhetorical, discursive, and material acts. This is biocapitalism operating
not merely as a system of exchange, but rather as what Rajan (2006) calls a foundational
epistemology, producing foundational symbolic (and subsequently economic) value. I would
concur with Rajan that the sorts of knowledge produced through these processes allows us to
conceive of life in general (and therefore, of autistic life in particular) in certain ways, while
simultaneously making it more difficult for us to conceive of autistic life in ways that are
incongruent with the AIC’s organizing epistemological architecture. Within this epistemological
framework, it is not only autism as a disembodied ontological category or ideas about autistic life
that are being produced as legible (and others ideas rendered inconceivable)—this framework
also manufactures the very identities of autistic people. Therefore, the third primary product that
the AIC manufactures within its infrastructure is less a form of symbolic capital and, rather, is
arguably the most material product in its entire line—the identities and selves of autistic people.

Futurity and Capacitation

In her essay “Cripping Neoliberal Futurity: Making the Elsewhere and Elsewhen of Desiring
Otherwise,” Kelly Fritsch (2016) considers the consequential question of precisely which
disabled futures are envisioned, anticipated, and actively capacitated within neoliberal
calculations of risk. She argues that, “through practices of neoliberal biocapitalism, the lack of
tractable futures for some disabled people works alongside the tractable futures of enhanced or
capacitated disabled people, embedding crip futurities within the inequitable inclusion practices
of neoliberalism” (p. 11). In other words, she argues that “the material discursive practices of
neoliberal biocapitalism have enabled the tractability and flourishing of particular disabled
futures while other disabled futures remain unanticipated, unexpected, and undesired” (p. 11).
Her discussion is worth quoting here at some length:
The withering of some disabled lives and the capacitation of others result from neoliberal material and discursive
processes that orient and imagine disability as a life without a future unless capacitated through such biocapitalist
practices as cures or body/mind enhancement technologies and procedures (see Fritsch 2015). Neoliberal futurity
organizes disability in such a way so as to make disability intelligible through the suffering disabled child who is never
imagined or anticipated to grow up or have a life worth living. Through neoliberal futurity, this suffering disabled child is
figured as the negation of the future, or as a subject with no future. At the same time, however, neoliberal futurity also
speaks to the difference of the futures imagined for some disabled children: biocapitalist futures, premised on the hope of
overcoming disability through cure or body/mind enhancement. (pp. 11–12)
This discussion perfectly captures and encapsulates the mechanisms operating within the
apparatus of the AIC: neoliberal conceptualizations of futurity within the AIC actively organize
and constitute and produce autism in such a way as to make autism intelligible only through the
rhetorical representation of the suffering autistic child, who is never imagined or anticipated to
grow up or to have a life (present or future) worth living. This suffering autistic child is a
necessary figure in the manufactured narrative of the AIC—this is the child in need of rescue,
recovery, cure. In this particular case, the suffering autistic child in need of recovery functions as
a narrative cipher, which is arguably less an identity per se than a rhetorical and narrative
function. The cipher is a subject with no future. Unless, of course, that child’s future becomes
capacitated through biocapitalist (in this case, predominantly ABA) intervention, in the hopes of
“overcoming disability” or, in this case, “recovering” the autistic child to a normative identity
within this desired and desirable neoliberal futurity.
Indeed the very existence of that autistic child arguably also is perceived to preclude the
normative futurity that the nonautistic parent may have imagined or envisioned for their child, a
future that this (autistic) child robs them of, or at very least threatens the imagined
materialization of (Sinclair, 1993). This is the economic structures of neoliberal capitalism
“manifest[ing] the proliferation of debilitation, using aspirational tropes for cover” (Puar, 2017,
p. 87). And “perniciously,” Puar observes, “capitalism is also invested in producing and
sustaining disability and debility.” Disability, according to Puar, whether as a vehicle for
capacitation or debilitation, “is good—meaning, profitable—for neoliberal capitalism” (p. 87).
And in a further Orwellian twist, that autistic child’s body, subjected to debilitating processes of
“capacitation,” simultaneously thereby capacitates the profit extraction potential of the neoliberal
capitalist autism industries.
For years, Autism Speaks and other autism media players spun the (false) narrative that there
were virtually no autistic adults, that the entirety of the autism so-called epidemic consisted of
the current generation of autistic children, and therefore all of our societal resources (efforts,
time, attention, and money) needed to concentrate on and be devoted to “recovering” them
before we ended up with a “tsunami” of intractable, undesirable autistic adults in a generation’s
time. The lack of representation of autistic adults on Autism Speak’s board for its first several
years was arguably not merely an ableist oversight on their part, and they were surely not
actually unaware of the large and increasingly well-organized, vocal, and activist community of
autistic adults (who were making their presence amply known to the leadership of Autism
Speaks). Rather, the biocapitalist present (in which ABA is being deployed in widespread and
highly lucrative fashion) is itself entirely predicated on the neoliberal phantasm of autistic
children having no future, and so the mere existence of autistic adults who had reached
adulthood not through the biocapitalist capacitation of ABA were themselves a material negation
of the AIC’s phantasmic future, in which autistic children are rhetorically posited to have no
future. It is little wonder that the AIC’s media infrastructure pretended that autistic adults by and
large didn’t exist, save those who were trotted out at conferences and at media events as subjects
of desired and desirable neoliberal futurity—the outcome of successful biocapitalist capacitation.
Yet both capacitated futurities (the marketed hope) and spectral futurities of institutionalization
(the marketed fear) serve to induce economic consumption in the autism intervention and
prevention marketplaces.

(Non)Futurity and Existential Negation

Beyond the suffering (and insufferable) future identity of continuing to be autistic—which is

barely legible within AIC futurity, as such devalued futures exist only as an engine to animate
the various industries of the AIC—or the valued future identity as biocapacitated (through ABA
intervention technologies) and therefore less autistic, the AIC has little on offer for autistic
people in terms of identity. Indeed, arguably, in terms of identity production, there are few
options for autistic identity within the biocapitalist rubrics of the AIC that are not toxic,
alienating, and violent. Within the biocapitalist project of the AIC, autistic bodies primarily
function as commodities from which to extract capital; therefore, valued and valuable autistic
identities are superfluous to the AIC beyond those of biocapacitation, which serve primarily as
“aspirational tropes for cover” (Puar, 2017, p. 87). And those desirable, biotechnologically
enhanced (“recovered”) autistic futures are desired, by and large, precisely because they are not
autistic futures (or, at very least, are less autistic futures, giving the appearance or approximation
of normativity). These envisioned biocapitalist, capacitated, and tractible futures both predicate
and animate the autism intervention industries.
And yet, within the AIC the indefinite extraction of profit from the commodity of autism may
eventually rest not upon the existence of autistic bodies at all. Rather, it may rest upon the
continued manufacture and widespread consumption of the spectral fear of the potential future
existence of autistic bodies fueling pursuit of the biocapitalist holy grail of the AIC: the
biotechnological development and universal deployment of prenatal testing for autism. And
within this framework, it is less a question of futurity than one of nonfuturity, in terms of autistic
identity. Thus the spectral fear of future autistic people symbolically drives both the intervention
and prevention industries, although the intervention industry generates the biocapacitated
(nonautistic) future identity, whereas the prevention industry generates the desirable futurity of
one’s own negation. It is nonautistic people’s desire for the nonfuturity—the existential negation
—of autistic people that predicates and animates the autism prevention industries, and within this
organizing grammar, one is confronted with the spectral future absence of others like oneself
(thus, anticipating one’s own extinction), leaving little but a vacuum in terms of orchestrated
(non)identities.
Indeed, one cannot help but also reflect upon the very real possibility of one’s actual personal
existential negation, whether as desired by others or as a material risk. Sinclair (1993) said it best
when they explained to an audience of nonautistic parents:

Therefore, when parents say, I wish my child did not have autism, what they're really saying is, I wish the autistic child I
have did not exist, and I had a different (nonautistic) child instead. Read that again. This is what we hear when you mourn
over our existence. This is what we hear when you pray for a cure. This is what we know, when you tell us of your
fondest hopes and dreams for us: that your greatest wish is that one day we will cease to be, and strangers you can love
will move in behind our faces. (n.p.)

And this kind of rhetoric not only fuels the profit potential of both the intervention and
prevention industries, it also fuels the cultural belief that autistic lives are inherently less valuable
and not worth living, which in turn fuels real and material acts of violence against existing
autistic people—up to and including death at the hands of their parents or caregivers.
Since 2012, the autistic community in solidarity with other disabled communities has
gathered on March 1st to observe a Disability Community Day of Mourning, to honor the lives
of those disabled people killed by their own family members or caregivers (ASAN, n.d.).
Rhetoric is devastatingly material. Katie McCarron, an autistic toddler, was killed by her mother
in 2006, just days after the release of Autism Speaks’s fundraising film Autism Every Day, in
which Alison Tepper Singer recounts (within visual shot and earshot of her autistic daughter,
Jody) having contemplated killing her by driving the car off the George Washington Bridge (she
obviously did not) (see Broderick, 2010). Shortly after the death of the autistic George Hodgins,
Zoe Gross (2012) penned a chilling poetic essay appropriately titled “Killing Words,” in which
she calls such murders “copycat crimes,” following as they so often do on the heels of
sympathetic (for the perpetrator) media coverage of a previous autistic person’s murder. Thus, in
addition to the menacing spectral future wherein others like oneself no longer exist, the specter
of one’s own potential nonfuturity is thus never far from the front of one’s mind, either, if one is
an autistic person living (in precarity) within the AIC.
Thus, whereas Rajan (2006) argues that biocapitalism enables us to grammatically conceive
of certain forms of life and living (e.g., in this case, as the suffering autistic child with no future,
or as the biocapitalist-capacitated “recovered” autistic), the biocapitalist project also actively
debilitates one’s own imagined futurity within the AIC. I argue further that the AIC
simultaneously obscures and nearly obliviates our capacity to conceive of autistic life in other
ways, outside of the narrowly circumscribed grammars and subjectivities of the AIC. These are
the limited and limiting identities being forged in the fires of the AIC—the possibilities
orchestrated (Dolmage, 2018) by the materiality of rhetoric enmeshed with capital. But what are
the possibilities obscured? Are suffering, tractable, biocapacitated, or nonexistent identities our
only options for being autistic in neoliberal times? To quote the preeminent autistic rhetorician
M. Remi Yergeau (2017): Fuck no.

(Endemic) Precarity and (Autistic) Futurity (Or, Endemic Damage, Ghosts, and
Monsters, with Thanks to Tsing)

In closing, I explore what possibilities for autistic futurities may look like, despite the limited
and limiting neoliberal biocapitalist rubrics of the AIC. Puar (2017) contends that disaster
capitalism (or, simply, capitalism) “promotes the maintenance of the ‘disaster’ of disability as
debility—endemic, durational, and profitable” (p. 88). But normative and endemic disaster,
debility, and precarity (profitable and hegemonic though they may be) nevertheless need not
foreclose alternative possibilities. Capitalism thrives precisely because it is relentlessly tenacious
and infinitely adaptable. So is (autistic) life.
Anthropologist Anna Lowenhaupt Tsing (2015) contends that precarity is increasingly
endemic to contemporary lived experience. I began pulling this manuscript together in January of
2020 and am completing it mid-2021; the events of the past year make it impossible to argue or
to contest Tsing’s premise, 2020 being the poster child year for endemic precarity, damage, and
violence. Tsing joins with colleagues in exploring this state of endemic precarity further in their
kaleidoscopic edited collection of essays in the anthropological text, Arts of Living on a
Damaged Planet (Tsing et al., 2017). Contributors explore the artistry involved in surviving the
damaged and damaging landscapes of the Anthropocene epoch—on a planet damaged by
carelessness, contempt, lack of stewardship, and, frankly, capitalist and colonizing pillage for
short-sighted profit and gain.
The conceit of the essays collected in Arts of Living on a Damaged Planet is that the
Anthropocene is entangled with what they call ghosts (landscapes haunted by the violences of
modernity and biocapitalism) and monsters (the materialities of inter- and intraspecies sociality
and symbiosis). In one introduction (of two) to the text, Swanson et al. (2017) write, “While
ghosts . . . help us read life’s enmeshment in landscapes, monsters point us toward life’s
symbiotic entanglement across bodies” (p. M2). Further, they write:

Against the fable of Progress, ghosts guide us through haunted lives and landscapes. Against the conceit of the Individual,
 monsters highlight symbiosis, the enfolding of bodies within bodies in evolution and in every ecological niche. In
dialectical fashion, ghosts and monsters unsettle anthropos, the Greek term for “human,” from its presumed center stage
in the Anthropocene by highlighting the webs of histories and bodies from which a life, including human life, emerges.
(pp. M2–M3)

Read more narrowly, this heuristic of ghosts and monsters can also enable a generative reading
of the AIC: a critical reading of the AIC as a project of biocapitalism also requires of us a
disruption of the fable of progress—is “normal” better? Is a world without autism (and therefore,
without autistic people) “progress”? Does this futurity offer a utopic vision? Or a dystopic one?
The haunted landscapes of the AIC pervade and surround us; we need only attend to them. Is that
so difficult to do? Apparently, the answer is yes.
In the other introduction to this text, Gan et al. (2017) refer to this phenomenon as “refusal of
the past” and remind us that “Our era of human destruction has trained our eyes only on the
immediate promises of power and profits. This refusal of the past, and even the present, will
condemn us to continue fouling our own nests” (p. G2). Gan et al. write further of the ontological
impact of this forgetting, this refusal, this erasure:
As humans reshape the landscape, we forget what was there before . . . . Our newly shaped and ruined landscapes become
the new reality. Admiring one landscape and its biological entanglements often entails forgetting many others. Forgetting,
in itself, remakes landscapes, as we privilege some assemblages over others. Yet ghosts remind us. Ghosts point to our
forgetting . . . (p. G6)

The AIC has been engaged in a decades-long project of reshaping the landscape of autistic and
allistic life and, crucially, their symbiosis. We have forgotten that, prior to the building of the
AIC, Donald and Frederick were described by Kanner (1971) as “the able bank teller and the
duplicating machine operator,” while Richard and Charles were described as having shared the
“dismal fate of [living] in a State Hospital environment” (p. 144). We have forgotten Kephart’s
(1998) rhetorical query, “What, in the end, are you fighting for: Normal? Is normal possible?
Can it be defined? . . . And is normal superior to what the child inherently is, to what he aspires
to, fights to become, every second of his day?” (p. 11). We have forgotten that valuable and
valued ways of being autistic in the world exist, have long existed, and hopefully will continue to
exist despite the hegemonic landscape of the AIC and its biocapitalist project of cultural and
genetic and existential forgetting. This analysis of the AIC (hopefully) illuminates that
forgetting, and the ghosts it excavates throughout (hopefully) collectively resist that erasure.
To return to the intersection of precarity with futurity, recall that the project of the AIC is
premised on a very particular manifestation of futurity: a modernist, neoliberal, biopolitical, and
biocapitalist futurity that refuses and forgets autistic pasts and presents in order to advance its
own marketed futurity, comprising either biocapitalist-capacitated futures or the future absence
of autistic people altogether, but forgetting and refusal are not the only forms of violence nor the
only sources of precarity for autistic people within this apparatus. Tsing et al. (2017) engage
throughout their text with the weight of extinction events and their particular hauntings of our
contemporary landscapes, but also with the futurity of extinction events, when they write,
“Ghosts remind us that we live in an impossible present—a time of rupture, a world haunted with
the threat of extinction” (p. G6). This particular form of precarity may be described as
What anthropologist Deborah Bird Rose calls “double death,” that is, extinction, which extinguishes times yet to come.
Rose has argued that white Australian settlers brought with them a particular, and peculiar, kind of time. They looked
straight ahead to the future, a singular path of optimism and salvation informing their dreams and deeds . . . . Moving
toward this future requires ruthless ambition—and the willingness to participate in great projects of destruction while
ignoring extinction as collateral damage. (p. G7, emphases in original)
The biocapitalist and settler colonialist futurities advanced by the AIC are quite literally
existential threats to autistic people, futurities that leverage the explicit threat (marketed as
“hope” to nonautistic consumers) of a “world in which autism doesn’t exist.” And never forget
that a world without autism is in fact a world without autistic people. Moving toward this future
requires a willingness to participate in projects of great destruction, while ruthlessly ignoring an
intraspecies extinction event as collateral damage. Gan et al. remind us that

every landscape is haunted by past ways of life . . . . Anthropogenic landscapes are also haunted by imagined futures. We
are willing to turn things into rubble, destroy atmospheres, sell out companion species in exchange for dreamworlds of
progress. (p. G2, emphasis in original)

These are the hauntings of the AIC—the willingness to deny existence to future autistic
people and to sell out existing autistic people to the fever dream of “recovering” those very
people to an imagined future state of normalcy that erases the future existence of autistic people
—the extinguishing not only of existing autistic life but of autistic life yet to come. According to
Gan et al. (2017), the problem with extinction events is not just the loss of individuals, nor of all
of their type, but rather, the larger problem is the loss “of assemblages, some of which we may
not even know about, some of which will not recover,” the loss of “long-evolving coordinations
and interdependencies” (p. G4). Nonautistic people desiring the eradication of autistic people
may not (yet) perceive the assemblages, the coordinations, and interdependencies that have long
existed, some of which may not be recovered if eradicated. Where would the sciences be,
without assemblages involving autistic people? Mathematics? Computer science? Literature and
rhetoric? The arts? Our own families, loved ones, histories, genealogies? Be careful what you
wish for. We are enmeshed.

Orchestrating Diverse, Polyphonic Possibilities

But what of autistic futurities? What might it look like to imagine a more just and livable future
for autistic people (as well as to conjure a more autistic imaginary of just and livable futures for
us all), in coordinated and interdependent assemblage? Rajan (2006) posited that biocapitalism
shifts the very grammar of life to future tense. I contend that the future tense is not the only verb
tense at play in the interstitial spaces of the AIC, nor indeed within biocapitalist landscapes
generally: we have also at our disposal the underutilized subjunctive. The subjunctive is the verb
tense denoting the possible, the wished-for, the imagined—“if it were,” “should it be.” It’s not
difficult to be gaslit by the simple future tense: “it will be.” To frame one’s work (and
fundraising) as working toward a future in which “autism will no longer exist” is to conjure an
ontological sense of certainty through sheer grammatical force of will (pun intended). The
subjunctive couches the future in uncertainty, liminality, but also possibility: it reminds us that
the future is up for grabs. The subjunctive both erodes the ontological dominance of biocapitalist
futurities while also enabling the conjuring and the emergence of autistic futurities in its
interstices. What if the orienting grammar of autistic futurities were the subjunctive? Might that
offer what Gan et al. (2017) call the “gift of hope . . . of the possibility of living-with” (p. G11)?
Precarity is indeed endemic—to life on our planet, to life in our fractured and damaged civil
cultures and societies, and to life as an autistic person living within the epistemological and
ontological hegemony of the AIC. Roscigno (2019) argues that we really don’t know at this
juncture what autism absent trauma looks like because of the endemic nature of the intrusive
intervention complex and the chronic trauma of the experience of autistic life in an allistic and
ableist society. These and other forms of endemic violence engender precarity—persistent,
chronic, endemic precarity. And this specific precarity is overlaid upon foundations of even more
profound precarity—the precarity of the damages wrought by biocapitalism upon our cultures,
our planet, our very ways of being alive, necessitating what Tsing et al. (2017) call the “arts” of
living on this damaged planet, in this endemic violence and within its precarity.
So—we only have the one planet, but is it even possible to operate outside of, beyond, in
active subversion of capitalism itself? Mitchell and Snyder (2015) argue not outside of or
beyond, but offer their excavation of biopolitics to generate subversion of or even insurgency
against neoliberalism: “Rather than posit a space outside of neoliberal capitalism, the biopolitics
of disability explores how forms of dissent evolve within limiting rubrics of neoliberal diversity”
(p. 219), or what they refer to as “forms of insubordination within global capitalism” (p. 206).
And just as the distributed networks of the AIC are ad hoc, loosely affiliated, and sometimes
even operate in competition with one another, so, too, I argue are the possibilities for collective
—albeit nonunified—forms of dissent and subversion exercised with/in, and even with/out, the
AIC. And these forms of collective though nonunified living are themselves forms not only of
subversion or insurgency, but in their enactment also forms of artistry, aesthetics, poetics. Gan et
al. (2017) write, “To survive, we need to relearn multiple forms of curiosity. Curiosity is an
attunement to multispecies entanglement, complexity, and the shimmer all around us” (p. G11).
Autistics are nothing if not curious and attuned to the complexity and the shimmer all around us.
How might that curiosity, and attunement to the shimmers of autistic lives be(come) reciprocated
by allistic communities?
I cannot help but evoke in this moment the image and the example of the matsutake
mushroom explored in glorious, rich, complex, and nuanced detail by Tsing (2015) in her
brilliantly rendered The Mushroom at the End of the World: On the Possibility of Life in
Capitalist Ruins. Tsing’s text is a multispecies anthropological study of matsutake mushrooms
and the strange underground economy around their cultivation, collection, and distribution. The
matsutake is a rare and valuable aromatic mushroom whose defining features are the ability to
grow within and among various detritus and an economy built by those often marginalized by
traditional markets—foragers. Tsing’s text provides a rich case study of how to both exist within
the confines of late-stage capitalism and resist capitalism as a totalizing, grand narrative of
progress in order to create possibilities—in the case of the matsutake foragers, a life in the woods
that evades some of the traumas of mainstream society. Tsing describes how matsutake gathering
is a project of collective survival and argues that unintentional coordination develops as an
assemblage, one that is both contaminated and polyphonous. I offer in closing three incomplete,
brief, diverse, polyphonic (that is to say, both harmonic and dissonant) possibilities for conjuring
autistic futurities. These subjunctive possibilities deploy the arts of survival with/in (and possibly
with/out?) the AIC, in the limiting rubrics and even the ruins of neoliberal biocapitalism (which
is not to say after capitalism, but rather, within it and pervading it and despite it).
First, in recognition of those denied futurity through the rhetorical and material violence of
the AIC, I honor mobilization and resistance and survival in the present tense, through the daily,
corporeal resistances that occur in the various spaces and immediacies of containment within the
AIC: the clinic, the group home, the school, the therapy practice. Roscigno (2019, 2020) has
plotted some of these resistances found within the corpus of ABA scholarship. Specifically,
Roscigno references, and I index here, the “head-bangers,” “biters,” “runners,” and “shit-
smearers” that slow the AIC through their physical resistance, even when such resistance is not
complete, cogent, or part of some larger activist program, and even when such resistance is
undertaken with enormous personal risk. This is what Roscigno (2019) characterizes as
“liberation outside of the courtroom, the policy document, the inclusive classroom, situating
resistance in the racialized/disabled body; considering what resistance means when the only
liberation available is to bite the teacher” (p. 13). Tsing characterizes such activity as a “latent
commons” (p. 255), which she describes in the negative, arguing that “latent commons don’t
institutionalize well,” stating “[a]ttempts to turn the commons into policy are commendably
brave, but they do not capture the effervescence of this latent commons. The latent commons
moves in law’s interstices; it is catalyzed by infraction, infection, inattention‚—and poaching”
(p. 255). These temporal, bodily resistances form a latent commons that allows for resistant
activity outside of grand, redemptive progress narratives or fables.
We must continue to live and act in the present tense, and to honor the labor and the courage
of those bound to the present by the repressive biopolitical technologies their bodies are currently
and routinely subjected to. Baggs (2019) describes these corporeal acts of resistance as an
essential expression of “self-advocacy”:

Self-advocacy has been and is still often labeled intransigence, noncompliance, treatment resistance, lack of motivation,
behavior issues, violence, manipulation, game-playing, attention-seeking, bad attitude, bad influence, babbling nonsense,
self-injurious behavior, inappropriate behavior, disrespect, disruption of the milieu, catatonic behavior, social withdrawal,
delusions, septal rage syndrome, and even seizures or reflex activity.

The daily, corporeal resistance of the autistic child to the AIC—the biting, the screaming, the
noncompliance, the passive and active forms of bodily insubordination that collectively form a
latent commons—these are the acts of freedom fighters, saboteurs, isolated members of an
underground resistance that fight on a daily basis with their own bodies (the only defensive
weapon available to them), not necessarily even knowing if there is a wider resistance
movement, not necessarily even experiencing the luxury of cognizance of the solidarity of
others’ resistance, outside of this space that their bodies occupy, this time that their bodies
endure.
Secondly, I recognize the importance of the Neurodiversity/Autistic Pride movement in
forging an important coalition and site of resistance and in both desiring and conjuring through
direct political action a material elsewhere and elsewhen of disabed existence (Kafer, 2013;
Fritsch, 2016). This coalition has organized and mobilized in the active present tense, coupled
throughout with explicit invocation of the past tense, naming the ghosts haunting the present
violent landscape and documenting the history of autistic communities. The neurodiversity
movement has cripped neoliberal biocapitalist futurities by making material gains for autistic
people in education, health care, employment, housing, etc., through public education, advocacy,
and policy work, all of which confound hegemonic futurities of autistic life. Organizations such
as the Autistic Self Advocacy Network (ASAN) and Autistic Women and Non-Binary Network
(AWN) have helped to bring attention to autistic people as a marginalized group and to usurp
some of the power of parent and professional organizations. Arguably the most important
contribution of the neurodiversity movement has been creating a language, platform, and
infrastructure to help autistic people find one another, organize, commune, and to create vital
support networks outside of the AIC. Mutual aid projects such as the Fund for Community
Reparations for Autistic People of Color’s Interdependence, Survival, and Empowerment
organized by Lydia X. Z. Brown, Morénike Giwa Onaiwu, Sharon daVanport, and Sara María
Acevedo have provided important survival resources for autistic people and thwart the AIC’s
aims of extracting as much capital as possible from autistic people, instead directing capital
toward autistic people.
This is explicitly Autistic futurity, and materially, it has accomplished a great deal. However,
I promised both polyphonous and also dissonant possibilities, so in closing, I explore autist-ic (as
opposed to Autistic) futurities that do not reinscribe the binary ontological constructs of autistic
and nonautistic, or Autistic and Allistic. These autist-ic futurities proceed without reference to
autism as a cultural or neurotypological identity and implicitly question the relevance and
meaning of the underlying binarism of such ontological categories. What of the arts of living in
Aut-/all-nonbinarism? Aut-/all-fluidity? Aut-/all-nonconformity? What forms of survival and
even thriving might such arts of living engender?
The term disability is a linguistic binary, morphologically speaking, and as such constrains
our thinking within binary boundaries (e.g., disabled and nondisabled). We simply do not have
(in English) the nonbinary conceptual vocabulary analogous to gender or race. Imagine if the
concept of gender did not exist, and the closest piece of vocabulary we had were fe/maleness.
Were we restricted to talking and writing about fe/maleness, we might find it difficult to imagine
and articulate gender fluidity, gender nonconformity (which itself is a rejection of both binarism
and cis-presentation), or gender nonbinarism. Autism is not a linguistic binary (nor is autistic);
why, then, do we persist in binding our own conceptualizations (and therefore ontologies) within
the binaries of “being” autistic or nonautistic?
It is this final possibility that offers perhaps the most resonant evocation of Tsing’s matsutake
mushrooms: that is the collective of autist-ic people who (wittingly or unwittingly) successfully
evade the apparatus of the AIC by either (a) operating under the radar or in “stealth mode” within
the educational and medical industrial complexes themselves, or (b) operating “off-grid,” which
is to say more or less outside of the formal education and medical industrial complexes. The
former may be described as a form of disidentification, and may potentially be critiqued as
“passing” by some who are invested in the utility of a disabled/nondisabled or autistic/allistic
binary. Nevertheless, such disidentification—borne of a cynical assessment of the possibilities of
(and indeed, the limitations of) identity politics as the organizing foundation of political action
and, therefore, as strategic and potentially subversive to the AIC—can just as easily be described
as a subversive form of decommodification of autism itself (and therefore, of autistic people).
Whether strategic or not, this “stealth mode” may nevertheless be understood as a form of
subjunctive grammatical orientation to futurity and is itself an art of living on this damaged
planet, within the precarity of the AIC. This possibility, this autist-ic futurity, generates a form of
what Tsing (2015) refers to as “contaminated diversity” (p. 29), which “changes the work we
imagine for names, including ethnicities and species” (p. 29)—and, I argue, identities—vis-à-vis
ontological constructs such as autistic and nonautistic. What might the “work” of “autism” in
terms of (dis)identification be(come)? What forms of living might such artistry conjure? What
might contamination (e.g., erasure of a binary) of autistic with allistic mean, should such
contamination eventuate?
The latter of these examples of evading the apparatus of the AIC (i.e., operating “off-grid”) is
an increasingly common experience for a widening range of people. By this I mean autistic
people who build lives and who thrive in the “ruins”—not seeking diagnosis, paperwork,
intervention or accommodation, but a space wherein they might live and thrive without reference
to such constructs. These are the people who make their living and build their community in
asynchronous, digital, noncentralized, and gig-based economies, or in flexible employment in
intersections of technology, the arts, and analytic fields where autistic experience is an asset
rather than a liability. These are the autistic children thriving in free-range,
unschooling/deschooling/homeschooling networks, developing their talents, interests, and
strengths without reference to a schooling system that sees them as fundamentally deficient and
in need of fixing (i.e., becoming, or at least appearing, less autistic). There is precarity in this,
yes, but precarity, as Tsing (2015) points out to us, is increasingly endemic to contemporary
lived experience. Curiosity about these ways of living in subversion of or without reference to
the AIC might be what she calls “the first requirement of collaborative survival in precarious
times” (p. 2). And we are living in precarious times.
Precarity is endemic to our times. Violence is also endemic to our times, in both obvious and
more subtle ways. And capitalism is epistemologically and ontologically hegemonic—it is not
“endemic to” our times; it is our times, ontologically speaking. Rajan (2006) argues that
biocapitalism and its biotechnological emergences constitute “a game that is constantly played in
the future in order to generate the present that enables the future” (p. 34). And that game, played
in the future to generate the present that enables the future, is also and simultaneously played in
the present to obliviate the past that generated the present that enables the future (with apologies
for the wibbly-wobbly, timey-wimey stuff). In other words, future-oriented the biocapitalist
project of the AIC may be (with additional apologies for the Yoda syntax); however, resistance
to and subversion and undermining of the futures-oriented AIC requires grammatical
engagements across tenses and temporalities. It requires deep and persistent and ongoing
historical and archaeological excavations of the foundational history and bedrock of the AIC. It
has not always been there: it was built, conjured, created, manufactured, produced, not out of
thin air but out of ideologies, rhetorics, branding, business plans, policy lobbying, media
saturation, capital investment, and—never forget—the bodies of autistic people.
We must continue to speak in the past tense; we must articulate over and over again the
ghosts of the AIC—we must say their names. Katie McCarron. George Hodgins. They are
legion. We must persist in corporeal incursions in the present tense—there is beauty as well as
strength in day-to-day survival. And just as ghosts haunt the landscapes and disrupt the “fable of
progress,” so, too, do monsters belie the myth of the individual. Entanglements trouble the
narratives that underlie biocapitalist futurities. Autist-ic futurities must be conjured now, while
autistic people to conjure them still exist. Should the subjunctive promise of contaminated
diversity yield possibilities for living on this damaged planet, for ways of living with/in and
with/out the AIC, would we notice those possibilities in time? Monsters lay bare our
entanglements, our symbioses, and, according to Swanson et al. (2017), such “[c]ontamination
often acts as a ‘tracer’—a way to see relations. We notice connections in part through their
ruination . . . . It is urgent that we start paying attention to more of our companions before we kill
them off entirely” (p. M8).
If the AIC is a project of biocapitalism (and it is), each of these brief explorations (and
infinite others) offer subjunctive possibilities for engaging in the project of collective survival
with/in the damaging rubrics of the AIC. There is no overturning, there is no revolution, there is
no systematic dismantling: there is collective assemblage—contaminated, dissonant,
polyphonous. And if there were, should there be ways of living with/out the AIC, they will exist
in part because we collectively envision a future that generates the present that enables that
future. These multiplicities of identities, forged both with/in—but also with/out and despite and
in subversion of—the AIC, may in their assemblages constitute a project not of biocapital, but
one of collective autist-ic—and therefore human—survival.

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ABOUT THE AUTHOR

ALICIA A. BRODERICK is a Professor of Education at Montclair State University in New

Jersey, U.S.A. She is a Disability Studies (DS) scholar and a scholar of Critical Autism Studies
(CAS). For the past two decades, she has published critical scholarship on autism deploying a
variety of interdisciplinary conceptual frameworks, including critical discourse analysis, rhetoric,
cultural studies, and historically situated analyses of ideology, metaphor, and narrative. Her
present analysis synthesizes and reframes much of her extant work by deploying the overarching
epistemological and ontological lens of neoliberal capitalism in analyzing the shifting meanings
of autism within capitalism over the past 75 years.

ROBIN ROSCIGNO is a Ph.D. Candidate at the Rutgers University Graduate School of

Education. Her research focuses on ethical, affirming education for Autistic and otherwise
neurodivergent children and eradicating school-based forms of curative violence such as restraint
and seclusion. She also runs a successful TikTok account about Autism, education and advocacy
under the name AuTeach, and her work can be seen in Ms. Magazine, TEDx, Rolling Stone, Tilt
Parenting and more.
INDEX

A
ABA (see Applied Behavior Analysis)
ABA Business Boom, 196–197
ABAI (see Association for Behavior Analysis International)
ablecapitalism, 31
ableism/ableist, 3, 12, 28, 60–61, 99, 127, 157, 161, 248, 257, 273, 280
ablenationalism, 6, 19, 31, 249, 258
ADHD (see attention deficit hyperactivity disorder)
AGP (see Autism Genome Project)
AGRE (see Autism Genetic Resource Exchange)
AIC (see Autism Industrial Complex)
AirCrib, 56
Albrecht, Gary, 5–6, 11, 17, 41, 211
alienation, 252, 254, 263–264
Althusser, Louis, 259
APBA (see Association of Professional Behavior Analysts)
applied behavior analysis (ABA), 4, 7, 14, 16, 21, 23, 29–30, 40–45, 49, 53–72, 75–96, 99–128,
131–165, 169–208, 228–230, 245, 248–258, 263, 265, 272–273, 281
and post-traumatic stress, 254–255
billing codes (see CPT codes)
consultancy firms, 4, 174, 235, 249
ethical analysis of, 10, 91–92, 114, 125–128, 161–164, 177, 183–188, 252–259, 262
health insurance funding for, 3–4, 15, 29, 183–206, 222
industry, 7, 65, 131, 163, 169, 172, 180, 184, 191, 196–197, 200–206, 248–249, 256
intervention, 21, 23, 44, 57, 61, 69–72, 75–76, 80, 99–110, 113, 118–119, 122–126,
135–137, 141–142, 151–170, 174–208, 228, 245, 252–273
medically necessary, as, 188, 191–196, 202
reputational currency of practitioners, 44, 114, 119, 143, 163, 175–187, 198, 226, 233, 255
state licensure of practitioners, 119–120, 175–188, 195, 197
ASA (see Autism Society of America)
ASAN (see Autistic Self Advocacy Network)
ASAT (see Association for Science in Autism Treatment)
ASD (see autism spectrum disorder)
ASF (see Autism Science Foundation)
Asperger, Hans, 30–31, 44, 136, 150
Asperger Syndrome, 31, 148
assemblage(s), 244–245, 259, 266, 277, 279, 281, 286
Association for Behavior Analysis International (ABAI), 174, 177, 181, 184, 197, 255
Association for Science in Autism Treatment (ASAT), 106, 179, 229
attention deficit hyperactivity disorder (ADHD), 149, 247
autism,
and capitalism, 5–12, 16, 27, 243–244
as big business, 4, 7
as catastrophic, tragic, hopeless, 61, 81–84, 127, 131, 135, 161, 212, 222
as commodity/commodification of, xv, 1, 3–4, 7–8, 10–11, 13–23, 27–28, 32, 46, 49, 55,
127, 132, 135, 138, 146, 150, 159–162, 164–165, 169–170, 172, 187, 200, 206,
211–220, 236–237, 244–253, 261–265, 269–270, 274, 284
as disease, xv–xvi, 28, 71, 135, 137, 151, 158, 189, 191, 195, 201–202, 215, 218, 235, 270
as enemy, xvi–xvii, 3, 8, 23, 71, 132, 135–139, 189, 194, 215
as neurodiversity, xv–xvii, 11, 283
as ontological category, 1, 16, 23, 28, 30–37, 39, 52, 54–56, 61, 69, 71, 76, 101, 147, 170,
211, 215, 230, 244, 247, 259, 261, 269–271
as rhetoric, xv–xvi, 8, 53–54, 56–57, 101, 113–114, 120, 127–128, 135–139, 147–150,
164–165, 189–195, 259, 272
as social problem, 11, 17, 18, 20, 22, 27–30, 34–46, 62–63, 71, 114, 127, 212
cultural politics of, xi, 6, 11–12, 16, 22, 49, 56, 76, 125, 138, 151, 189, 212, 241, 244
cure for, xv–xvii, 83, 91, 139, 151, 160, 190, 216, 221, 230–232, 272, 275
discourse, 5, 37, 54, 58, 82
economics of, 8–11, 69, 146, 212
epidemic, 3, 8, 21, 23, 34, 135–139, 145–150, 189, 191, 194–195, 213, 215, 231, 273
eradication of, 28, 190, 216, 224, 227–228, 231–232, 279
etiology of, 34, 36–39, 62–63, 65, 137, 217
industry(ies), xv, 4, 7–8, 10, 15, 17, 19, 32, 56–57, 71–72, 96, 99, 146, 150, 164, 170, 191,
204–205, 211–212, 214–216, 223, 225, 234–238, 273
markets, xv, xvi, 1, 3–4, 8, 10–23, 28, 41, 44–46, 49, 55–57, 62–65, 69, 71–72, 76–78, 83,
86, 95, 104, 114, 127–128, 131–165, 169–170, 171–172, 176, 178, 180, 184, 198–208,
213–216, 228–230, 237–238, 245, 253–259, 262–281
metaphors, xvi, 3–4, 8, 22–23, 38, 89, 136–137, 152, 189, 215, 224
narratives, xvii, 3–4, 8–10, 13–14, 19–21, 28, 36, 38–40, 43, 46, 52, 54, 59, 62–65, 75–76,
81, 85, 92, 99, 113–114, 120, 136, 139–140, 145–147, 159, 162, 183, 195, 197, 252,
265, 272–273
political economy of, 4, 6–11, 22, 55, 190, 241, 245–246, 260, 266
prenatal screening for, 215, 245
research funding, 9, 133, 136–138, 147, 152, 211, 217–238,
rhetoric, 8, 56–57, 85, 189
vaccines and, 102, 211, 224–231, 233, 235
autism/ABA industry, 7
Autism Canada, xvi
Autism CARES Act, xvi, 217–218, 230
Autism Culture Wars, 132–139, 151
Autism Every Day, 227, 275
Autism Genetic Resource Exchange (AGRE), 224
Autism Genome Project (AGP), 224
Autism Industrial Complex, 1, 4, 7, 12–23
commodities of, xv,1, 3, 7, 10–11, 13, 15–16, 20–23, 32, 46, 49, 55, 135, 146, 159,
164–165, 169–170, 172, 187, 200, 211, 216, 220, 237, 253, 263–265, 269, 274
 consumers of, 1, 3, 16, 19–20, 23, 46, 49, 55, 57, 66, 69–72, 76, 127, 135, 138, 165,
173–187, 278
diagnostic subsector, 145–150, 220
epiphenomenal features, 1, 15, 17, 212
foundational plutocrats of, 14, 49, 172, 220–234
ideological products of, 1, 15, 16, 28, 55, 69, 114
networks, 14, 49, 172, 220, 222, 234–237, 280
pharmaceutical subsector, 208
Autism Investor Summit, 198–208
Autism Research International, 105
Autism Science Foundation (ASF), 155, 226–230
Autism Society of America (ASA), xvi, 37, 155
Autism Speaks, xvii, 3, 14, 49, 135–139, 155, 170, 172, 188–197, 205, 206, 216, 220, 223–237,
266, 273, 275
Government Relations, 193–194
Grassroots Advocacy Network, 192–194
rebrand, 2020, 231–233
autism spectrum disorder (ASD), 10, 126, 148–149, 155–156, 185, 205, 207, 231, 255, 256
Autism Votes (see Autism Speaks, Grassroots Advocacy Network)
autistic bodies, xv, 7, 14–16, 19–20, 22, 101, 134, 146, 170, 172, 206, 211–212, 241, 250–251,
262, 269–274, 285
commodification of, 14–16, 19–20, 146, 170, 172, 206, 211–212, 262, 269–274
autistic futurity(ies), 241, 269, 276, 279–283
autistic identity(ies), 6, 14, 22, 71, 157, 220, 261, 270–271, 274
Autistic Self Advocacy Network (ASAN), 151, 275, 283
Autós Consulting and Advisory Solutions, 235
aversive punishments, contingent, 40, 52, 58, 118, 163–164, 247, 253
Aydarova, Elena, 139

B
BACB (see Behavior Analyst Certification Board)
Bartleby, 143
Behavior Analyst Certification Board (BACB), 3–4, 14, 29, 49, 170, 172–188, 195, 204, 220,
255
certifications, 173–174
history of, 172–176
licensure debate, 175, 176–184
Professional Code of Ethics of, 175, 185–188
Behavior Technician, Registered (see Registered Behavior Technician)
behaviorism, operant, 16, 29, 40–45, 49, 62, 65, 67, 69, 90, 138, 140–141
Bettelheim, Bruno, 35, 37, 61, 136, 224
BCaBA (see Board Certified Assistant Behavior Analyst)
BCBA (see Board Certified Behavior Analyst)
BCBA-D (see Board Certified Behavior Analyst-Doctoral)
biocapital, xvii, 241, 243–246, 253, 255, 259–266, 269–286
bioethics, 126, 185, 187, 253,
biophilanthropy, 251–252
biopolitical technologies of control, 22, 243, 245–254
biopolitics/biopower, 6, 244–246, 249–254, 257–258, 262, 278, 280
biosurveillance technologies, 245
Blackstone Group, 208
blank slates (see also tabula rasa), 139–146
Bleuler, Eugen, 30
Board Certified Assistant Behavior Analyst (BCaBA), 173
Board Certified Behavior Analyst (BCBA), 4, 29, 106, 173, 176, 184, 198,
Board Certified Behavior Analyst- Doctoral (BCBA-D), 173
branding/(re)branding, xvi, 11, 14, 16, 21, 28, 40, 45, 49, 51–72, 76, 78, 83, 86, 88, 99–106,
113–120, 127, 131–135, 140, 143, 153, 170, 176, 181, 187, 203, 205–206, 211, 223–224,
228–233, 237–238, 245, 259, 265, 285
building a person, 142–143, 151–152, 162
Bumiller, Kristen, 9
Bush, George W., xvi, 144

C
CAA (see Combating Autism Act)
CAN (see Cure Autism Now)
capacitation, 31, 253, 257–258, 271–276, 278,
capitalism
as epistemology, 246, 258–259, 281
carceral, 17–18
disaster, 133–135, 141, 276
neoliberal, xv, xvii, 5, 7, 11, 16, 19–22, 27, 32, 44–46, 55, 133–140, 187, 195, 204, 212,
214–215, 228, 236, 244, 247, 251, 258–260, 272, 280
CARD (see Center for Autism and Related Disorders)
CAS (see Critical Autism Studies)
CDC (Centers for Disease Control and Prevention)
Center for Autism and Related Disorders (CARD), 208
Centers for Disease Control and Prevention, U.S. federal government (CDC), 153–158, 201
CNVs (see copy number variants)
Cohen, Shirley, 60, 76–78, 87, 90
Coles, Gerald, 120
Combating Autism Act (CAA), xvi, 138, 189, 191, 192, 216–218, 234
copy number variants (CNVs), 218
CPT codes (see Current Procedural Technology codes)
Critical Autism Studies (CAS), 7, 8–10, 20, 258
cultural logics of intervention, prevention (see intervention, cultural logic of and prevention,
cultural logic of)
Cure Autism Now (CAN), 221–222, 224, 233
Current Procedural Technology (CPT) codes, 196–197

D
Danforth, Scot, i, xii
Davidson, Joyce, 10
Dawson, Michelle, 7, 122–124, 143, 160–161
Day of Mourning, Disability Community, 275
debility, debiliation, 31, 253, 257–258, 264, 272–273, 275–276,
debt, commodity of, 17–18
as consumption, 18
therapeutic, 18, 23, 262–263
Deer, Brian, 225
Delivering Scientific Innovation for Autism, LLC (DELSIA), 235
DELSIA (see Delivering Scientific Innovation for Autism, LLC)
Developmental Models of Autism Intervention (DMAI), 124, 169
diagnosis regime, 31, 150
Diagnostic and Statistical Manual of Mental Disorders, second edition (DSM-II), 147
Diagnostic and Statistical Manual of Mental Disorders, third edition (DSM-III), 147, 152
Diagnostic and Statistical Manual of Mental Disorders, third edition, revised (DSM-III-R), 147
Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM-IV), 148
Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-V), 148
disability
and capitalism, 5–6
as social problem, 5–6
business, 5
industry, 5–6
political economy of, 5–6
Disability Studies (DS), 53–54, 258
disaster capitalism (see capitalism, disaster)
dispossession, 18–19, 250, 258
DMAI (see Developmental Models of Autism Intervention)
Dolmage, Jay, 53, 58, 78, 101, 113, 120, 127, 189
DS (see Disability Studies)
DSM-II (see Diagnostic and Statistical Manual of Mental Disorders, second edition)
DSM-III (see Diagnostic and Statistical Manual of Mental Disorders, third edition)
DSM-III-R (see Diagnostic and Statistical Manual of Mental Disorders, third edition, revised)
DSM-IV (see Diagnostic and Statistical Manual of Mental Disorders, fourth edition)
DSM-V (see Diagnostic and Statistical Manual of Mental Disorders, fifth edition)

E
educational industrial complex, 12–14, 233, 236
Eisenhower, Dwight D., 12, 14, 15, 171
embodiment, peripheral, 6, 249–251
ethics, ethical analysis, 10, 91–92, 104, 125–128, 161–164, 175–177, 183–187, 213–214, 225,
245, 252–262, 270
evidence-based intervention, 4, 22, 115–117, 227, 253, 259
eugenics, 12, 28, 53, 58, 59, 216, 227–228, 231
Expression of Concern, 162–163

F
Farrall Instrument Company, 41–42, 159
FBP (see Feminine Boys Project)
fear, rhetoric of, 3, 21, 49, 60–61, 71, 128, 131–165, 190, 212–213, 215, 225, 266, 269, 273–274
Feminine Boys Project (FBP), 143, 151, 159–161
flexians, 233–238
Foucault, Michel, 100–102, 119–120, 244–246, 251
Friedman, Milton, 51, 134, 136, 140–144, 171
Fritsch, Kelly, 271–272
futures markets, 216
futurity, 170, 212, 241, 253, 260–261, 265, 269–286

G
Gan, Elaine, 277–281
Geiger, Angela, 231
genetic research, 217–228
funding, 9, 211, 217–223
styles of thought, 218
Genomic Prediction, 214–215
genomic research, 224–230
funding, 211, 219–223
styles of thought, 218
Gernsbacher, Morton Ann, 121–124
Goodley, Dan, 10
grammar(s), 101–102, 150, 187, 265, 270, 274–275, 279–280
Grandin, Temple, 87
Granpeesheh, Doreen, 208
Great Lakes Feminist Geography Collective, xi
Green, Gina, 106, 108, 109, 111–112, 114, 178–184
Greenfeld, Josh, 63, 66–69
Grinker, Roy Richard, 8, 11, 18–19, 146–149
Gross, Zoe, 151, 275

H
Haack, Susan, 102–104, 113, 120, 125, 225
Hacking, Ian, 8, 145–147
Haraway, Donna, 110
Harding, Warren G., 58–59
Harvey, David, 18, 51–52, 55, 99, 218
health disparities
experienced by LGBTQ people, 154
experienced by Autistic people, 157
Hodgins, George, 275, 286
hope, rhetoric of, 3, 10, 21, 28, 34, 37–40, 43–49, 51–72, 75–96, 99–107, 113, 127–128,
131–135, 138, 140–142, 161, 165, 190, 212–214, 221, 245, 253, 260, 266, 272–273, 275,
278
Human Genome Project, 215, 221–222, 259
Hunter, James Davison, 132–133
Hurricane Katrina, 144

I
IACC (see Interagency Autism Coordinating Committee)
IDEA (see Individuals with Disabilities Education Act)
IDEIA (see Individuals with Disabilities Education Improvement Act)
Individuals with Disabilities Education Act (IDEA), 119, 148, 149 autism as category of
eligibility, 148
Individuals with Disabilities Education Improvement Act (IDEIA), 4
Institute of Medicine Report, 226
Interagency Autism Coordinating Committee (IACC), 234
Internal Revenue Service, U.S. federal government (IRS), 172–174, 188–189, 192
intervention, autism
cultural logic of, xv–xvi, 1, 3, 4, 8, 11, 14, 16, 17, 20–23, 27–46, 49, 55–72, 76–96,
99–128, 164, 169–170, 171–208, 211–212, 215–216, 227, 237, 270
industry, 4, 8, 9, 11, 15, 17, 19–20, 22–23, 27–46, 52, 55, 58, 61, 71–72, 132–135,
138–139, 149, 159–160, 164, 169–170, 171–208, 212, 215–216, 218, 220–223, 229,
238, 255–256, 262–263, 274–275
interventionist narratives, 3, 8, 63
Ireland, Gregg E., 228
IRS (see Internal Revenue Service, U.S. federal government)
Iverson, Portia, 221

J
JABA (see Journal of Applied Behavior Analysis)
JADD (see Journal of Autism and Developmental Disorders)
Johnston, James, 175, 179–184
Journal of Applied Behavior Analysis (JABA), 40–42, 44, 53, 162–164
Journal of Autism and Developmental Disorders (JADD), 217

K
Kaerus Bioscience Ltd., 235
Kanner, Leo, 30, 32–35, 38, 62, 64–65, 92, 131, 136, 147, 224, 277
Kaufman, Barry, 82
Kephart, Beth, 95, 278
Klein, Naomi, 134–136, 144
Kupferstein, Henny, 254–255

L
Lancet, 122–123, 225–226
Latif, Saquib, 10
LD (see learning disability)
Leaf, Justin, 255
learning disability (LD), 120
Levy, Susan 122–124
LGBTQ identity, politics, 151–164
Life, 38, 41
Lobbyists/lobbying, 4, 14, 22, 136, 138, 174, 180–183, 188–197, 223, 227–228, 231, 236–237,
285
London, Eric, 226–228, 230
London, Karen, 226–228
Longmore, Paul, 5–6
Lovaas, Ole Ivar, 38, 41, 43–44, 56–71, 76–93, 105–106, 108, 116–119, 121–125, 131, 135, 138,
140–153, 159–164, 206, 208, 212, 265,
lumpenproletariat, 18–19, 23,
Luxemburg, Rosa, 18

M
Mallett, Rebecca, 8, 10, 11, 15, 23
Mandell, David, 123–124
Market Research Future, 207
marketing, 17, 21, 28, 45, 49, 56, 71, 76, 78, 83, 86, 95, 104, 132–133, 135, 138, 159, 176, 194,
196, 198, 205–206, 214, 244–245, 259, 266
Martin, Eric, 103, 114, 125
Marx, Karl, 5, 18–19, 244–246, 258–259, 262
Maurice, Catherine, 36–38, 57, 60, 67–70, 76–96, 104–119, 131, 135, 148, 178
McCarron, Katie, 275
McChesney, Robert, 45, 86
McGuire, Anne, xii, xv–xvii, 7–8, 10, 15, 17, 138–139, 146
medical industrial complex, 12–13, 284
metaphors, autism (see Autism, metaphors)
military industrial complex, 12–15, 127, 171
Milton, Damian, 7
Mingus, Mia, 12–13
Mitchell, David T., 6, 19, 31, 249–251, 258, 280
Model Act for Licensing/Regulating Behavior Analysts, 182
Model Behavior Analyst Licensure Act, 182
Morris, Diane, 196–201, 230
Mountz, Alison, xi
MSSNG, 233

N
NAAR (see National Alliance for Autism Research)
Nadesan, Majia Holmer, 9
National Autistic Society, xvi
National Institutes of Health (NIH), 218–219
National Society for Autistic Children (NSAC), 37–39, 46, 62–64, 105, 221
Naturalistic Developmental Behavioral Intervention (NDBI), 123–124
NBC Universal, 136, 155, 227
NDBI (see Naturalistic Developmental Behavioral Intervention)
Ne’eman, Ari, xv–xvi
neoliberalism, 6, 16, 45–46, 51–52, 55, 71, 86, 134–141, 171, 180, 184, 225, 236, 249, 258, 263,
271, 280
and austerity, 9–11, 23, 69
and privatization, 9–11, 22, 128, 136
neurodiversity, xv–xvii, 11, 283
New York State Department of Health, 108, 115–118
 Clinical Practice Guideline for Assessment and Intervention of Young Children with
Autism/ Pervasive Developmental Disorder, 115–119, 121
Guideline Technical Report, 115–119
Report of the Recommendations, 117
Quick Reference Guide, 117
NIH (see National Institutes of Health)
nonprofit corporations, 14, 106, 135, 170–197, 220–223, 231, 233–238, 255–256
IRS regulations, 173–174, 188–189, 192
normalcy, 44, 52, 56, 58–64, 69–71, 75, 81, 86–96, 99, 113, 135, 152, 214, 279
NSAC (see National Society for Autistic Children)

O
Ontario, Canada, 151–153, 162
operant behaviorism (see behaviorism, operant)
Orsini, Michael, 10

P
parents, nonautistic, of autistic children, xvi, 9, 11, 14, 17, 19–21, 23, 28, 35–39, 44, 46, 49, 52,
58–71, 75–77, 79–82, 84–87, 92–96, 99–100, 105–111, 117–118, 126, 131, 135–138, 148,
156–157, 161, 165, 190, 220–222, 226–228, 234, 236, 249, 251–254, 265, 272, 274–275,
283
PDD-NOS (see Developmental Disorder, Not Otherwise Specified)
Pearson, 4, 174, 184
peripheral embodiment (see embodiment, peripheral)
personhood, 143, 151,
Pervasive Developmental Disorder, Not Otherwise Specified (PDD-NOS), 147–148
pharmaceutical intervention/research/ industry for autism, 9, 12, 117, 123, 149, 152, 169,
207–208, 218, 230, 245, 247
philanthro-capitalism (see venture philanthropy)
phonics wars, 120
Picciano, Anthony, 13, 233–237
political economy, 4–11, 18–22, 55, 100, 104, 125, 190, 241, 244–246, 258, 260, 266, 270
positivism/positivist, 21, 30, 57, 70, 78, 90, 95, 111–126
power/knowledge, 100
precarity, endemic, 276, 280
prenatal testing
and autism, 214–216, 229, 245, 269, 274
and Down syndrome, 213–215
prevalence data
for LGBTQ youth, 156–158
for autistic youth, 145, 156–158, 206–207
prevention, autism
cultural logic of, xv, 1, 9, 11, 14, 17, 20, 28, 49, 169, 172, 211–238, 270
industry, 8, 72, 114, 133, 137, 139, 160, 170, 188, 190, 211–238, 262, 265, 273–275
Psychology Today, 141
psychopharmacological funding, 218, 230, 245
Puar, Jasbir, 31, 134, 253, 257–258, 264, 272–274, 276
Pyne, Jake, 151–153, 162,

R
Rajan, Kaushik Sunder, 187, 241, 244–246, 258–266, 269–271, 275, 279, 285
randomized controlled trials (RCT), 123–124
RBT (see Registered Behavior Technician)
RCT (see randomized controlled trials)
“recovery (to normalcy)”, 56–72, 75–96, 99, 104, 113, 120–121, 125, 127, 131, 135, 137–138,
215–217, 245, 265–266, 272
refrigerator mother, theory of, 36, 224
Regalado, Antonio, 214–215
Registered Behavior Technician (RBT), 173–174, 199, 264
Rekers, George, 143, 160–163
Relias Industries, 196–199
restraint and seclusion, 248–251, 258
rights-based discourses, 151–152, 159, 253–259
Rimland, Bernard, 37–39, 62–63, 82, 87, 105, 108, 110, 114, 136, 221
Ring, Robert, 225, 234–236
Roscigno, Robin, ix, xi, 3, 27, 250–253, 258, 280–282
Runswick-Cole, Katherine, 8, 10–11, 15, 23
Russell, Marta, 5

S
Saltman, Kenneth, 246–250, 257
Sandbank, Micheal, 123–124
Sandoval-Norton, Aileen, 255
Schuller, Kyla, 251
scientism, 21, 102–104, 107, 113–125, 184, 194, 245, 253
SEAB (see Society for the Experimental Analysis of Behavior)
shadow elite, 233–236
Sheffer, Edith, 31–32, 150
shock doctrine, the, 134–136
Simons Foundation, 217
Singer, Alison Tepper, 155, 227–236, 275
Singh, Jennifer, 216–229
Skinner, B. F., 29–30, 56, 65, 106, 138–141, 206
Smith, Tristram, 91–92, 122–124, 142
Snyder, Sharon L., 6, 19, 31, 249–251, 258, 280
Society for the Experimental Analysis of Behavior (SEAB), 162–163
subjunctive (verb) tense, 280–286
Sullivan, Ruth, 36–39
Surgeon General, U.S., 118–119

T
tabula rasa (see also blank slate), 141–145, 153, 159
TEACCH, 169
telethon industry, 6
Thomson, Rosemarie Garland, 95
Timimi, Sami, 10
Trump, Donald T., 58, 136, 217
truth
politics/political economy of, 100–104
regimes of, 114–120
Tsing, Anna Lowenhaupt, 241, 276–285

U
UCLA (see University of California, Los Angeles)
University of California, Los Angeles (UCLA), 63, 66–67, 88, 92, 143, 151–152, 160–161
utopia/n/ist, 139–144

V
value (economic), 18, 23, 187, 207, 241, 246, 251, 258, 260–263, 271, 273
venture capital, 170–172, 196–238
venture philanthropy, 228, 235
Verified Market Research, 207
visually keyed shocker, 41–43, 159

W
Wakefield, Andrew, 225–226, 236
Wall Street Rides FAR, 228
Wang, Jackie, 17–18, 28, 61, 262
Wedel, Janine, 233–236
Weschler Intelligence Scale for Children, Revised (WISC-R), 59, 77, 91
Wiley Periodicals, LLC, 162
Wiklenfeld, Daniel, 126, 185, 252
wireless shocker, 41-44, 52, 56-57, 65, 159
WISC-R (see Weschler Intelligence Scale for Children, Revised)
Wright, Suzanne, 136, 190, 232-233
Wright, Robert (Bob), 136, 227, 232-234

Y
YAP (see Young Autism Project)
Yergeau, M. Remi, 43, 54, 59, 147, 276
Young Autism Project (YAP), 57-58, 66-67, 88-89, 143, 151, 163-164

Z
Zhang, Sarah, 213-215