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I work mainly with preteen and teen populations who heavily to moderatly impacted by Autism. Many are only partial vocal verbal and some have significant cognitive issues. I have also helped with the younger early intervention group and know the children in this group resist treatment heavily, they can often be herd screaming NO to each task or even at times throwing physical tantrums. I have never believed in pushing treatment during these situations, thats why I work with preteens and teenagers who are more capable of understanding the reason and agreeing to treatment. However I also understand how much faster and how much more productive treatment is in early intervention. Its like catching cancer when its still localized to one tumor instead of all over the body, some minor changes in early childhood can prevent a lifetime of social challenges that will prevent social isolation leading to deep depression and anxiety as adults. Early intervention kids aren’t capable of this type of reason even if the comprehension is there, thats why they can’t refuse things like cancer treatment and it might not be ethical to allow refusal of behavior treatment. I do however believe treatment can easy crossover into trauma that has its own caviots so there are lines to be drawn a child spending 4-8 hours screaming and crying for mom is probably not going to lead to psychologically healthy endings. In my teen population I often find when I am training new staff there are things, usually the more difficult tasks, they do not want to do, probably suggestive of ego protection, as they will often return to doing them when its just us. I have also found heavy parent influence and desire to please as a contributing factor in assent no matter the age. 

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