A Football Great’s Scorching Tale of Severe Autism

“The Warner Boys” is the perfect antidote to neurodiversity nonsense — and offers an unexpected bonus for science

The Warner family.

The Warner family.

By Jill Escher

I remember two years ago hearing about a former pro football player coming “out of the autism closet” and sharing with the world his family’s plight of having two severely affected sons. At the time I didn’t pay much attention, but I suppose it’s never too late to catch up with what turns out to be one of the best autism memoirs I’ve read.

Curt Warner earned his fame back in the 1980s as a star running back for the Seattle Seahawks. Before that he was a two-time All-American at Penn State, known for his crafty, determined rushes. He was gentlemanly but tough. As his wife Ana remarked later, after getting pounded play after play in the NFL he would suffer injuries he didn’t even know about until after the game.

Curt and Ana wrote The Warner Boys together, with the assistance of sports journalist Dave Boling. I loved the book as soon as I saw the opening lines: “Our son Austin devoured books. Not reading them, eating them.” It’s this sort of candor about the highly dysfunctional autism suffered by both Austin and his twin brother Christian that makes the book worthy of an Autism Pulitzer, if there were such a thing.

Forget the “autism is neurodiversity” or “autism is like traveling to Holland instead of Paris” blather. In these pages it’s more like traveling through a mini-hell, dreading what heart-stabbing nightmare lurks around the corner — a dark tale they manage to convey with the biggest of hearts and an overwhelming love for their boys.

It all starts innocently enough. In a chance encounter, Curt meets Ana, a transplant from Brazil who was working multiple jobs trying to build an independent life for herself in the United States. She knew nothing about Curt or his fame, but from the moment she saw him went weak in the knees knowing “this was it.”

When Curt tore up his knee in his second season in the NFL, thanks to the terrible turf in the Kingdome, he underwent a complicated surgery involving removal of a ligament from his hamstring to rebuild his ACL, a pioneering surgery at the time. He underwent five more surgeries after that, on his knees and ankles. More about this topic at the end of this review.

Not long after, he had to retire from football and he started a new life as a businessman. The couple also wanted to pursue their dream of having children. Tragedy struck from the start. First came a beautiful boy named Ryan, stillborn. Then multiple miscarriages. Finally they had Jonathan, who went on to be a typically developing boy with an athletic streak. Nine months later they were pregnant again, with twins.

From the earliest years Austin and Christian failed to reach basic milestones. After the autism diagnosis, and as the boys grew older, their behaviors intensified. They relentlessly kicked holes in walls all over the house. Vicious head-banging landed Christian in the trauma ward. Austin’s lack of fear and elopement led to near-death experiences. The boys screamed and shrieked, and bit their hands and arms so often and severely it seemed they wouldn’t heal.

Every waking moment seemed fraught with mix of dread, exhaustion, puzzlement, heartache and financial drain. To endure the chaos and strain, Curt drew on lessons learned from his football days: “Sometimes you’re just getting beaten and there’s othing you can do about it…. You’ve got to line up and try it again. The next play, boom, you get clobbered again…. That’s pretty much what every day felt like for us for a long time.”

And Ana was beyond exhausted. After the boys were born she suffered post partum depression, then later, PTSD, then panic attacks (“My heart would pound so hard, and I’d have this overwhelming sense that I was going to lose it, just come undone”), then a deep, dark depression permeated with suicidal thoughts. On long drives near their home in Camas, Washington taken to calm the twins, she thought of ending it all, taking the boys with her, crying “so hard I could barely see.”

I appreciated Ana openly sharing the depths of her pain — such inner torments, though usually transient, are almost universal among severe autism parents, but far too seldom talked about.

But it was not the chaos that hurt the most, it was the boys’ inexplicable suffering. When Curt tried to hug and comfort the boys, you could feel his heartbreak leap off the page: “I would look into their eyes, and it’s like they were asking me, Why? Why is this happening to me?

So many other themes will resonate with autism families. For example, the divide-and-conquer strategy that prevented Ana from seeing many of big brother Jonathan’s sports events, the futility of the costly and complicated therapies, living in a lockdown house with extra locks, alarms, and fences, trying new diets, oddball micro-talents combined with functional incapacity: Austin could provide any detail of every Disney movie from the last decade or more, but he couldn’t tell you how many quarters make a dollar. Indeed Austin’s naive craftiness led to a mega disaster that I will let you discover on your own (though the title of this post offers a hint).

The narrative is also peppered with some non-preachy advice for couples finding themselves overwhelmed and stressed in the “strange new world of ASD.” Despite being a fierce competitor on the field, Curt never complained or “kept score” as couples often do. Following advice of a preacher the couple valued open communication. For Ana, faith and her love for God saved her in her darkest moments. The strongest glue, though, was an enduring mutual respect, a context that made the conflicts endurable.

As the book comes to a close, the Warners have adopted a lively little girl named Isabella, and the boys have become “full-grown adults, but unable to explain to anyone who they are, where they live, or that they suffer from a disorder.” My best guess is that the Warners’ deep concern about the future is what drove them to publicly divulge their intensely personal story. They remark that the autism tsunami means unprecedented waves of seriously disabled youth aging into adulthood in need of lifepan care, financial support, and structured supervision. As America ignores and sugar-coats the rising tide of disabling autism, The Warner Boys blares a wake-up call, seeming to cry, “Enough of the distractions, look at the disaster happening everywhere to our families.” That alone makes the book an important contribution to the literature — one that you should read and recommend to everyone you know who dares to try to normalize autism.

Now, a coda. 

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Why did this happen? Why would two perfectly healthy and intelligent people have not just one but two sons with severe autism and intellectual disability? The Warners write they never received any explanation from any clinician for their son’s disorders.

But I would like to suggest potential clues are right there in Chapter 2. As I said above, after serious injuries Curt underwent six surgeries in the latter part of his football career. Then not long after the succession of operations he and Ana started their family.

I have authored papers in scientific journals suggesting that in some cases general anesthesia (GA), particularly the sort used in surgery with modern inhalation anesthetics, can act as a potent germ cell toxicant, raising the risk for autism in offspring. 

What does that mean? Basically that GA can damage sperm or egg DNA or alter gene expression, with brain development genes being particularly susceptible to GA. It means that the offspring of the damaged germ cells could be at heightened risk for abnormal neurodevelopment, a phenomenon we see in the animal studies. I discuss this hypothesis in detail in a recent paper here, which was also profiled in Psychology Today here.

The fact that this rather obvious question of genetic toxicology is not even being entertained in mainstream autism research is in my view one of the greatest medical and research oversights of our time. I can only hope that stories like the Warners’ can provide a cautionary tale, not just about the dire reality of severe autism, but about a potent genotoxic exposure that may quietly be fueling a public health disaster. 

Jill Escher is the president of the National Council on Severe Autism. She is also an autism research philanthropist (Escher Fund for Autism), a member of the governing council of the Environmental Mutagenesis and Genomics Society, and the chair of BeyondGenes.

Disclaimer: Blogposts on the NCSA blog represent the opinions of the individual authors and not necessarily the views or positions of the NCSA or its board of directors.

Webinar: Accessing Public Benefits, a National Perspective, with Attorney Stephen Dale

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This webinar took place on Thursday, August 13, 2020

Stephen W. Dale, Esq., LL.M, is a dedicated disability rights advocate and principal attorney of the Dale Law Firm, P.C., based in California. The firm is dedicated to assisting individuals with disabilities with estate and special needs planning. This webinar covers the basics of both needs-based programs (SSI, Medicaid, SNAP) as well as entitlement programs (SSDI, Child Disability Benefits, Medicare). Steve also discusses how wage, unearned income, and resources effect medical benefits and continuing entitlement to Social Security benefits and/or eligibility for the SSI program. COVID related issues and Q&A were included.

Watch the recording on the NCSA YouTube channel here.

New study suggests more than 3% of Japanese children have autism

Increasing incidence mirrors alarming global trends

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By Jill Escher

Okaya is a city located in central Japan with a population of approximately 50,000. 

A new study by Daimei Sasayama et al. of Shinshu University School of Medicine, and published in the Journal of Autism and Developmental Disorders, indicates that after thorough screening 3% of the city’s children have autism.

The researchers evaluated the follow-ups of 1067 (517 boys and 550 girls) six year-olds who had also undergone a screening for ASD at there routine 18-months health checkup. In Japan, a health checkup is performed for all children at 18 months. The study subjects were children born between April 2009 and April 2012.

This study had two main objectives: (1) to present the cumulative incidence of ASD in an area with a thorough screening system, and (2) to examine the behavioral and motor characteristics observed at the age of 18 months in children later diagnosed as ASD.

Retrospectively, the questionnaire answered by caregivers at the 18-month-old checkup suggested that children later diagnosed with ASD showed delay in fine motor and gross motor skills and social and communication skills.

By the age of 6 years, 3.1% (4.3% of boys and 2.0% of girls) were diagnosed as having ASD by their attending pediatricians.

A similar incidence rate was reported in another cohort in Japan (Hamamatsu Birth Cohort for Mothers and Children) last year, where 3.1% of 952 children aged 32 months were found to have autism.

The study is consistent with global trends showing increasing autism rates among children. For example, nearly 2% of U.S. 8-year-old children were reported to have ASD based on CDC data. Northern Ireland reports a rate of 3.2% of schoolchildren. Recent Denmark data showed incidence may exceed 2.8%.

Other findings of the Okayashi study include:

• No significant difference in maternal or paternal age at birth was observed between ASD and non-ASD children. 

• No significant difference between ASD and non-ASD children was present in birthweight or head circumference at birth (controlling for sex) or at the 18-month checkup.

You can find the study (paywalled) here.

50 Shades of Re-homing

Enough with the pearl-clutching: re-homing of one form or another is common, and often necessary, with the severely autistic

By R Medina

A few weeks ago my social media got flooded with posts expressing moral outrage after there was news that a YouTube star and her husband had “re-homed” their severely autistic son, whom they had adopted from China. Apparently the son’s behaviors were more difficult and dangerous than they had bargained for so they found some way to place the boy with another family.

Now I don’t know anything about those YouTubers and this post is not about them or the boy’s autism. Was he a feces-smearer? Was he attacking his siblings? Did he screech at 2am, chew the drywall and break windows? I don’t know what prompted it. But this much I do know. Re-homing, in various direct and indirect forms, is entirely common with severe autism. In fact, one form or another is inevitable in most cases. All the sanctimonious judgment and social media pearl-clutching seemed based in obliviousness about what happens, over time with overwhelmed severe autism families, in the real world.

I would say there are at least 50 different shades of re-homing, from outright giving up custody to many more sublte forms. Clearly few pathways to re-homing are as early or overt as this case. But they all start from the same place, a single parent, couple, or sometimes caregiver sib who are so physically, mentally, emotionally, and/or financially exhausted or imperiled, or who have become so old or infirm, that they can no longer provide adequate care for the child or adult. Very often, as the children grow into adults, they become terrified of their strength and unpredictable violence.

Let me tell you about some of the shades. One is called “ward of the state.” I have a friend who is my age (46). Her younger brother had autism. But when he was young and the parents couldn’t take it any more, they made him a ward of the state. He now lives in a group home in a rural community about 500 miles from here, and his family members visit on rare occasion. When the parents relinquished him was there an uproar? Is there an uproar now? No.

Another shade is called “residential school.” This is a temporary form of re-homing. When an autistic child is too dangerous or destructive for a local school district and parents to handle, the IEP team will sometimes place the child in a residential school, often in another state like Kansas or Utah. Some of these schools are year-round, giving exhausted and overwhelmed parents a long break, with the hope of some improvement in skills and behaviors. When the the clock runs out on the IEP the parents are often faced with the difficult-to-impossible task of finding a new home for the young adult who has just fallen off the services cliff. 

Now let me tell you about the most common form of re-homing, it’s sort of a passive form, a kind of abandonment. It is called “parent (usually the father) has a sort of nervous breakdown and simply leaves.” I have seen this play out more times than I can count. The dad exits, and the child is re-homed to the care of a now single mother, often left impoverished and with little support. Where has the community outrage been when a dad leaves his disabled child — something that happens every day in this country, from what I can tell? Not a peep from the social media arbiters! A mom walks out and BLAMMO HASHTAG WARRIORS GO, but a dad? Here’s your free pass, sir.

Another shade is the group home. I used to work closely with a group home agency. Do you know what? Even people much more mildly disabled than those with severe autism were routinely placed in group homes. People really quite sweet, competent, capable. I never heard a speck of outrage when the families put them in group homes, permanently.

Another shade is inpatient care. When families hit the breaking point, they desperately seek an inpatient program where doctors and therapists could use drugs and therapy to help make the child or adult more manageable. This gives parents a break, sometimes for longer than you would know, I knew of a case like this that lasted almost two years. The single mother had her aggressive, self-injurious autistic son placed in an inpatient program and after that ended he could not return home, so he lives round-the-clock with 2 to 3 caregivers in a home rented through a government subsidy program. I do not pass judgment on her, she did exactly what she needed to do to survive. But it is a form of re-homing. And it deserves no condemnation.

I could go on with other examples, but I hope you see my point. With severe autism, re-homing by other names, other means, happens. All. The. Time.

Finally, can we please acknowledge two things. First, my work with families has shown me the the decision to place a severely disabled child or adult outside of the home is excruciating and heartbreaking for the parents, even for those parents covered in bitemarks and bruises, and who haven’t had a decent night’s sleep in years. It is never done lightly. It is the last resort, done out of desperation. Do not dare to pass judgment on these parents or mob them on social media unless you have walked a mile in their shoes.

One last lap here. Let’s acknowledge the darkest, most horrible truth of all. Parents are temporary. No matter how much they love their disabled kids, they will die. As they age we are in for wave upon wave of massive re-homing of severely autistic adults. Autistic re-homing is not an outlier, but a necessity, these adults have no ability to live on their own. Where they will go, I don’t know, but one thing is clear: whether we like it or not, re-homing is the future of autism.

R Medina is a pseudonym for a mom and disability community worker who lives in Southern California.

Disclaimer: Blogposts on the NCSA blog represent the opinions of the individual authors and not necessarily the views or positions of the NCSA or its board of directors.

New Study Points to Grim Outcomes for Adults with Autism

99% of adults diagnosed with autistic disorder as children are incapable of living independently.

With few exceptions, adults with autistic disorder lacked capacity to work or live independently. (Stock photo)

With few exceptions, adults with autistic disorder lacked capacity to work or live independently. (Stock photo)

By Jill Escher

Forget all the hype about autism as a superpower. A new study out of South Carolina following 187 people diagnosed with autistic disorder found their long-term outcomes to be overwhelmingly negative. A team under Roger Stevenson of the Greenwood Genetic Center published the paper, “Autistic Disorder: A 20 Year Chronicle,” in the Journal of Autism and Developmental Disorders in June.

The subjects were followed over a course of 20 years. They had been enrolled in the study during a three-year period from early 1995 to early 1998, and were between the ages of 1 and 21 at that starting point. All were receiving services for autism from the South Carolina Department of Disabilities and Special Needs. The subjects included 153 males and 34 females, representing a 4.5:1 male–female ratio. Sixty-six percent had white ancestry, 32% black ancestry and 2% other ancestry, numbers that parallel the population in South Carolina. Of the enrollees, 84% had co-occuring intellectual disability. The average IQ in the cohort was 49. Twenty years later, at the average age of 27, the investigators ascertained their outcomes.

The outcome data was grim, showing pervasive inability to live independently, hold a job, or manage money. Few became independent, with 99% unable to live independently. Of those, 70% lived at home with relatives, 21% lived in disability homes in the community, and 8% in residential facilities.

A mere 3.7% attained postsecondary education, about half of those representing certificates from college disability programs. While the majority were considered incapable of holding a job in the competitive workspace, some worked in disability workshops or other sheltered positions. Most participants were incapable of handling money, even with caretaker assistance, with only 9.5% considered capable.

The study also probed questionnaires and biological samples for patterns and causes. It found, for example, that 12% of siblings had autistic, mental health, or other behavioral manifestations, a figure that is in the ballpark of findings from similar studies, if somewhat lower. A review of genetic data revealed that 29 participants (about 15%) had genetic or genomic alterations considered to be pathogenic, but the genetic findings did not correlate with IQ. This rate is slightly higher than the 10% rate commonly seen in other studies, but since this cohort was limited to more severe forms of autism (autistic disorder under the DSM-IV is a segment more narrow than “ASD” under the DSM-5), and therefore possibly more likely to be suffering from genetic disease, this finding is not altogether surprising. In addition, 20 participants were born at or before 32 weeks gestation or had other possible prenatal or perinatal complications. No consistent or diagnostic facial dysmorphology was identified. Structural brain malformations were distinctly rare.

The study findings also underscored enormous unpopularity of the neurodiversity philosophy: fully 95% of parents or caretakers who responded to a study question relating to treatment overwhelmingly desired a cure if one were available.

Overall, the study provided a needed reality check about the long-term outcomes of children diagnosed with autistic disorder. Advocates might hype the idea of autism as a superpower or autistic adults becoming independent and capable of competitive integrated employment, but the data tell another, altogether more devastating story.

Jill Escher is the President of the National Council on Severe Autism.


Autism: It’s time to take the conversation back

“Our families must be heard, our loved ones deserve appropriate resources and services. The intentional blocking/censorship of the severe side of the spectrum must come to a end.”

The author with his family. It’s time for the families that have had the nightmare experiences of severe autism to be leading the conversation about the future of our disabled loved ones, he says.

The author with his family. It’s time for the families that have had the nightmare experiences of severe autism to be leading the conversation about the future of our disabled loved ones, he says.

By Vance Goforth

I’ve been actively advocating for changes regarding issues related to severe autism and severe behavioral disorders for over two years now. This process started after our son Joshua finally received treatment for severe autism and behavioral disorders that had been in crisis levels for years.

I experienced the devastating effects that a broken system had on my son and family and I’ve been screaming from the rooftops ever since. I have seen resistance and outright anger from those who would rather my viewpoint be censored than be addressed. This goes beyond disturbing for me and I find it outright ludicrous that those dealing with severe autism/related diagnoses have been totally dismissed by autism advocates and disability organizations that claim to represent our families.

It was hard enough for us to share our story publicly, but when a prominent disability organization heard about our son and talked to me about solutions, their response was “good luck, several other parents have said the very things you have and haven’t been successful in getting those changes.” Disheartening doesn’t even describe what I felt when I heard those words and also the fact that they weren’t even in the least bit interested in helping by speaking out about what my family had experienced.

I refuse to be talked over and talked down to anymore. It’s time to take the conversation back.

Our families must be heard, our loved ones deserve to be treated with respect and provided with appropriate resources and services. The intentional blocking/censorship of the severe side of the spectrum must come to a end.

I’m very tired of different forms of media asking about our story and saying they will cover the story and then when they find out that it‘s not one of those happy feel-good autism stories, I never hear from them again. This isn’t a shiny-gift autism that gets covered in the news so often, this is a gut-wrenching hard autism that is no cause for celebration for my family or the families that truly understand what I’m talking about. It’s devastating.

Families cannot get resources and services in the form of respite, therapies, in-home care, medication management, behavioral treatments, inpatient treatment (both acute and long term treatment). I know some states are better than others in providing services; but still, there is a widespread lack of needed support for families facing issues related to severe autism and other ID/DD disabilities.

We’re seeing respite resources having their budgets cut, even Medicaid waiver programs are being cut back or delayed like in my state. This is not the right direction, especially when considering that the autism rate continues to rise at an alarming rate.

We are one of thousands of families that can attest to the fact that treatment facilities are overwhelmed and the waitlists are grueling for those in need of immediate help. I’ve sent many emails and testified before state legislators about the need for more treatment centers. Here is the response that truly perplexed me and I’ve heard it more than once. “The state just closed all of the institutions, they will not be willing to explore the idea of adding new treatment facilities.”

What, what????? How is providing treatment facilities being equated with an institution? I don’t know the answer to this but it’s happening. We are already so behind the curve with the increased autism rates, it’s scary and very few are paying attention to the distress calls from families.

I personally know one family that is 3,400 miles from their child because of the shortage of treatment locations. How would you feel if this was your family? The pain and the stress these families face is indescribable. They feel hopeless and totally invisible in a system of advocates and organizations that considers it forbidden to discuss the hard issues of severe autism. Higher functioning advocates champion the closure of anything that is related to or even falsely described as an institution, while refusing to discuss multiple and overwhelming issues created by not providing suitable alternatives when these closures happen.

It’s time for the ones that have had the nightmare experiences of severe autism to be leading the conversations. We need more families to share the systemic inadequacies they face and we definitely need more organizations and legislators to have an open ear to the tsunami of challenges that are hitting families right now and getting worse with time.

Vance Goforth is the father of son with severe autism. He and his family live in Tennessee.

Like the Voice for Joshua Facebook page here: https://www.facebook.com/changeforjosh
Join the Voice for Joshua Facebook support group here

Read more from Vance here:
Walking on Eggshells, a Severe Autism Perspective
The Crisis Call No One Is Willing to Hear


Disclaimer: Blogposts on the NCSA blog represent the opinions of the individual authors and not necessarily the views or positions of the NCSA or its board of directors.