A top priority of any Model of Excellence Program will be to keep people with autism out of psychiatric hospitals and living in the community. To achieve that end, innovations in community models are being prepared. We have described the crises at home and in school that is leading in more and more cases to family breakdown, expulsions from school, and admissions to behavioral units and psychiatric hospitals. This can happen at any time in the life of a child, as the pressures and stresses become unmanageable. In our work in Malaysia, we identified about 10% of the families to be in a state of crisis or approaching crisis, with no knowledge of where to go or what to do. Some were already considering sending their child to specialist boarding schools in the UK. This is ironic, because parents in the UK are sending their children to boarding schools in the USA, and parents in the USA are sending their children to boarding schools in Australia, often based solely on the promises made in glossy brochures. These boarding schools are generally so expensive that families are having to mortgage their houses and sell their cars, to send their children away. Does anyone believe that sending a child with emotional and behavior problems half way around the world because nobody at home can cope with them is going to lead to a positive outcome for the child? Could not that money be better used to build communities closer to home so that the child does not have to be ripped out of their families, integrated schools and culturally appropriate settings?

The communities we envision include centers offering short- and medium-term therapeutic transition programs. The aim is not to remove the children from home and put them in boarding schools, but to provide a release from the environments of school and home that are leading to frustration and anger. The release can be for a few days to a few months, but the goal is to transition into a new situation where the child is on the way to becoming a young adult, with some independence, experience of the world, emotional maturity, better social skills and awareness of self. The centers would offer dietary, behavioral and educational programs, practical skills development, social skills training, crafts, outward-bound expeditions, sports and leisure activities. In these settings, the child will meet others going through the same transitions, and peer bonding will be a goal as they are put into situations where problem-solving will require co-operation and team-work. These centers can be staffed by a mixture of professionals and volunteers, and might include people with other disabilities, or conditions such as Down’s Syndrome as community staff, people who can inspire confidence through their ability to achieve great things despite their condition. The families will by no means be excluded from the programs, but rather will also receive training in behavioral strategies, nutrition and understanding of their child’s needs, strengths and potentials.