Simple, Universal Steps Can Transform Autism Care

Most change does not start with a new app or a new law. It starts with simple habits used by the people families meet first. In her NJACE 2025 keynote, behavior analyst Dr. Dorothea Lerman argued that autism care improves when we train non-ABA professionals—police, first responders, doctors, and dentists—to use a few reliable strategies in real settings. As she put it, “Our need is really… really big, but our reach right now is pretty small.” The fix: scale what already works.

Train the helpers that families see first

Lerman’s team embeds short, hands-on trainings inside existing programs. Police get skills during crisis-intervention courses. Medical and dental trainees practice in one-hour workshops. The point is pragmatism. You change behavior through practice, not slides. “You can’t just tell people about things and expect them to change their behavior.”

Two moves anchor the approach:

• Slow down and separate safety from distress. Officers learn to approach slowly, back off if agitation rises, and distinguish dangerous behavior from problematic behavior like yelling or stimming. Different situations need different responses. 
• Use clear, repeatable prompts and positive supports. Clinicians use brief, doable tools—“tell–show–do,” short breaks, praise after cooperation, and tiny step-ups in exams—to prevent escalation and finish care.
  

Make it universal

Because neurodiversity is not always visible, Lerman advises using these supports with everyone. “We didn’t focus on helping police officers figure out if someone has autism… we want them to think everybody does… and give everybody the benefit of the doubt.” Universal habits reduce judgment, lower stress, and improve safety.

Practice beats lecture

When officers added role-play to lecture, their performance improved more than lecture alone. In healthcare trainings, mean correct use of strategies reached 91%, with 85% meeting an 80% competency bar and 96% reporting higher confidence after a single 60-minute session. In dentistry, her team found that about half of patients flagged for sedation or restraint did not need it once staff tried these basic strategies first. The takeaway is not perfection; it is progress that sticks. “Be satisfied with what might be effective for some people. But not necessarily everyone.”

Why this matters

Families want safe, calm interactions—during a traffic stop, an ER visit, or a dental cleaning. Lerman’s core idea links two truths: small, universal steps help many people, and those steps spread only when we teach inside existing systems. Or as she put it, “Find a problem that that profession has, and show them you can solve that problem.”

Sources

• NJACE & RUCARES Annual Conference, Sept 16, 2025 — Keynote by Dr. Dorothea Lerman (transcript provided by organizer) 
• Concepts referenced by speaker: Diffusion of Innovations (Everett Rogers), CFIR (Consolidated Framework for Implementation Research), ERIC (Expert Recommendations for Implementing Change), ADA accreditation standards for disability training (as noted by speaker)