Oregon autism death raises awareness of how to help overwhelmed families

The arrest in Oregon of Jillian McCabe, who police say threw her 6-year-old autistic son off a bridge to his death, raises questions about what can be done to better support the parents of children with severe autism, and to better protect children with disabilities from potential abuse.

Ms. McCabe called 911 to report what she’d done to her son, London Grey McCabe, and told police she heard voices in her head, The Oregonian reported. Earlier this year, she had reached out for funds and prayers on YouCaring.com, describing how she was caring for both her son and her husband, who was unable to work because of a serious medical condition.

The case follows another in Michigan last year, in which Kelli Stapleton pleaded guilty to a felony charge of first-degree child abuse after shutting herself and her 14-year-old daughter Isabelle into a van with burning charcoal. The two were found unconscious from carbon monoxide poisoning. She was recently sentenced to 10 to 22 years in prison.

Ms. Stapleton had blogged about the difficulties of caring for Issy and the violence her daughter had sometimes unleashed upon her. After both recovered, she spoke about how she had envisioned the two of them having a happier relationship in heaven. At her sentencing hearing, experts spoke about psychiatric factors in her background that could have played a role.

“These are both clearly cases of people who were overwhelmed by many problems,” not just the challenge of having a child with autism, says Vincent Strully Jr., CEO and founder of The New England Center for Children, a private nonprofit school for children with autism.

But because of the spotlight on these cases, he says, “it is a time to say to people, ‘Do you have any idea what these folks who have challenging autistic children are going through?… Services are so scattered and uneven across the country….  They live in an eternal state of anxiety. Their worries and fears never go away.” 

Progress is being made – through state laws and changes to insurance through the Affordable Care Act. Thirty-seven states and the District of Columbia, for instance, have passed autism insurance reform laws, the advocacy group Autism Speaks reports. But whether it’s related to insurance or their children’s education, parents are still often “left to fend for themselves,” Mr. Strully says.

Ms. Stapleton had dedicated herself to working with Issy and helping improve her behavior, and Issy had also received intensive treatment at a residential facility. But shortly after she returned home, Issy began hitting her mother again, according to an account in New York Magazine. And the local high school where Issy was supposed to attend decided not to let her come. The carbon monoxide poisoning took place several days later.

In the United States, there are about 500 cases a year of a parent killing his or her child. That number has remained relatively stable even as the population has grown between 1976 and 2007, the years studied by Brown University researchers in 2014. Among the children killed, 72 percent were under 6 years old. Among the more than 15,000 cases, 57 percent involved fathers accused of the killing.

Forensic psychiatrist Phillip Resnick reviewed studies on maternal filicide (a mother killing her child) and found that many had depression, suicidal thoughts, psychosis, or previous mental health treatment. Among the five common motivations were altruism (the belief that the child will be better off if killed), acute psychosis (where the motive isn’t understandable and they commonly report hearing voices), and the child being unwanted or thought to pose a burden.

Dr. Resnick also found that 16 to 29 percent of filicides include the mother’s suicide. He recommended that psychiatrists inquire more about the children’s well-being among mentally ill mothers, and that the bar for hospitalizing them when they are suicidal should be set lower because of the potential for filicide.

Such cases point to the need for more progress in societal attitudes toward people with disabilities, because the historical notions that life with a disability isn’t worth living, or that life will be ruined for parents who have a severely disabled child, still persist, says Curt Decker, executive director of the National Disability Rights Network in Washington.

Combine these attitudes with the genuine frustration of failing to access needed resources, and it can “put parents under extreme stress to where they might do something untoward,” Mr. Decker says, though most find ways to cope.

Decker says he is monitoring a trend in which thousands of parents have inquired about the controversial “Ashley Treatment,” named after a severely disabled girl whose parents pursued medical treatment about a decade ago to stunt her growth and sterilize her, with the idea that they could better care for her and protect her. Decker says he’s particularly concerned that ethicists have supported this type of treatment by saying the burden on the parents needs to be weighed.

“This sort of devaluing a child with a disability to the point of dong things with [her] that we would just not accept for anybody else … is a very slippery slope,” Decker says.

The Autism Society, based in Bethesda, Md., has a contact center staffed by professionals that can be reached at 1-800-3-AUTISM.