employment, so i think our challenge is to look at how, with the resources that we have, children age out of school so there's a population constantly leaving childhood and entering childhood, but the adult program, adults with autism are living normal life spans, and so right at eden at this point, we have group homes and apartment programs, residential programs, and some of those guys have gotten up to their 60s, and we're looking at what is that next step? what kind of support can we provide them? i think the model that we had with the education and the children's act in 1975 really set an example of what can be done to help adults with dates and particularly autism as we go forward. the numbers are big, and we have to look at various streams of

funding that can help provide that support, and enable them to be productive in working to help support themselves. >> t to be productive in working to help support themselves. >> the chair recognizes, mr. payne, the ranking member. >> thank you very much. and thank you for prolonging the hearings so i could at least get here. i was in the senate filibustering and i appreciate being here. i had a long-standing engagement which was i was unable to alter but let me take the indulgence of the committee for a brief opening statement might be past tense now since you've testified but we looked at your testimony and i'm aware of what each one of you had to say.

but i certainly began my statement by thanking chairman smith and certainly let me reck his long-standing relationship both domestically and globally. i would also recommend our esteemed witnesses today and the testimony that you'd given and the testimony that we've heard on autism globally and how proposed interventions would coexist and complement our efforts to combat africa's leading killer disease, namely, hiv and aids and malaria and tropical diseases where we have the emphasis as is already mentioned by the chairman but issues like this which impact on so many others are left unintended. autism often identified by impairments and communication and social interaction is often recognized in early childhood, around the age of 3. imagine the news that one's

child, as you must have experienced, faces the challenges of autism and the devastation of hearing that this has beset your young child. fortunately, here in the united states and other developed countries progress has been made and our efforts to detect and treat those with the disorders, however, we still have a long way to go as you mentioned in yo your, mrs. kobenan. >> kobenan. >> kobenan. i never would have said it so nicely, kobenan. but as you testified ace read in your remarks about how you had to leave this region of the

country where you would think that in washington, d.c. and in this environment in m.d. and virginia where we would have the appropriate resources but you chose to move to arizona because you knew that there were better services. and so we can just imagine how in a developing country where many, many needs are, that autism is certainly an issue that seems to be -- and mental health in general tends to be put on the back burner than the other diseases that we hear so much about. in the u.s., there are public and private resources available for impacted families to better cope with the disease. sadly, the same support structures provided in developing world often do not exist in low and middle incomed countries due to inadequate

funding and a lack of understanding or diagnosis of the disorder. there's often neglected populations battling a wide range of mental, physical and neurological disabilities in countries further compounding the poverty, health systems and governments. the united nations had taken some important steps to ensure equal rights for those with disabilities including the 1981, the declaration by the united nations for the international year of disabled persons. then it established the united nations decade for disabled persons in 1983 to 1992. the u.n. then expanded the universal declaration of human rights to include people with disabilities some 35 years after the declaration was adopted and the united nations reaffirmed equal rights for people with disabilities through several -- for particularly the convention

on the rights of persons with disabilities in 2006 and declared on april the 2nd world autism day and so many times there is and actually unesco has really move forward none of addressing the problems with the framework for action to meet basic learning needs which calls on governments to pay special attention to the learning needs of the disabled and to take steps to provide equal access to education for every category of disabled persons as an integral part of the educational system kept of equal education for mentally and physically disabled people had been endorsed by several countries by the ratification of several international and regional agreements. so although we do hear criticism of the united nations, i think that many issues would have gone unspoken throughout the world if not for the united nations going

back 40 years ago recognizing that countries, especially, in low and middle incomed countries would not raise the issue of disability when they had so many basic issues like clean water or malaria, so i do commend them for that. there are certainly, as i mentioned a lot of private resources available for impacted families to better cope as here in the united states with the disease. support, sadly, the same support structure provided in developed world often does not exist in low and middle incomed countries due to inadequate funding and a lack of understanding or dying nodes of the disorder, there is an often-neglected population battling a wide range of physical, mental and neurological in developing countries further compounding the burden of poverty and weak health systems on families, communities and governments and the united nations has taken

these important steps as i mentioned before, however, the right to educate remains unattained for many autistic children in the developed world. while the united nations' actions are commendable. many developing christians failing to address the failing needs of their autistic population. the world health organization found that in middle and low-incomed countries there is only one child psychiatrist for every 4 million people. it's unbelievable. i look forward to what you have said and has been recorded. looking at low cost interventions, given their limited state budgets and overburdened public health systems which developing countries can apply and to better deal with the issues of autism within their borders. we know that there have been a number of several -- the journal of international association of

special education found that children with autism in africa do not share the same behavior signs as the western counterparts is very being such as rocking back and forth. it seems that geographic and environmental differences impact the way the disorder manifests itself which makes it very difficult because there is not one kind of treatment covers all. we look forward to how we might be able to work along with the fact that there are different signs. so furthermore, we know that from the haiti earthquake and other examples that in crisis situations, those with disabilities are often inadequately cared for. we know that this is a big problem, and so i once again would like to join with the chairman in certainly thanking

you for your appearance here and has for your interest. i have just a quick question or two since i almost exhausted my five minutes. i don't know how to tell time. but there appears to be limited information about the prevalence of autism worldwide especially in africa. what do you know about it in a nutshell about how widespread this disorder is in the world and in particularly in africa? and what are the greatest challenges in conducting autism prevalence studies abroad? would any of you like to try to take a stab at that? >> sure. so the challenges of conducting prevalent studies in africa is actually similar to hers it's about informing the community and the stakeholders so they can try to work with you. and we found when you have the community buy-in, you're

actually able to generate the highest quality data. and the greater challenge, i think, is actually the second act. to do a study in communities is one thing. but trying to figure out what are you going to do with all the individuals in the family who you identify in a study is completely different and requires a commitment not only to the individuals and families but also commitment to change, community, society and governments and that kind of work takes a long time. it takes a lot of resources. it takes a lot of focus. but at the same time, that kind of policy change will be meaningful only if you have real solutions on the ground. the ideas that you want to nurture and support and grow, things are already working for families on the ground. so going to any low and developing country, you need to

really approach it from a top-down as well as a bottom-up perspective. you need the top-down so the solution you develop on the bottom up is sustainable and can be integrated as a meaningful solution to the national public health system. >> i said it a minute ago and i will resay it again. one of the basic, basic challenges that we have are centers. you know, you can have a program to teach teachers to educate stakeholders and all that, but once the whole team is gone, whether you come from the united states, you teach these people and then you leave, where do the parent go for more information? they need to have a center. everybody have a house. they need to have a house that they call autism center. it doesn't have to be sophisticated but that's a major challenge. once they have those little centers, they can go there and

get information. and if anybody has any question, they can go there. they can have a small staff member that can have parts there and just work there just to educate people. that's the first step. >> do you think the church community or other developing countries can be a center if there could be an educational campaign to educate the religious community and simply ask if their parsonage or some part of their building could be used for that? >> yeah, that's a great point. indeed, that could absolution. when i say "center." it doesn't have to be a building. the ex-wife of the ambassador of liberia because they would use wives to get them to be involved. and she got involved. and cher solution was to talk to one of her church -- with her

pastors and see if he can give her a part of a building and he did. within a year she was able to do that. and she told me the center actually was created. so that's a very good suggestion, too. >> we might even go further and ask our u.s. department of state and usaid as they move forward on this that we might prod them on this issue and their ambassadors -- and they all have projects that they can fund little stipend that they could do and they don't even know that but if ambassadors' wives could have the women perhaps of the countries and courage them to have a meeting and then encourage the african community to, therefore, approach the hierarchy of the church, i think that we could, as you mentioned -- we don't need a lot of money.

we just need to use the resources and everyone needs a home, you're absolutely right. because i was late and i've taken enough time, i will yield back and ask no more questions. and i thank you very much. >> thank you, mr. chairman. just as a brief follow-up, ms. kobenan. you mentioned regarding your son and the brain mapping that was done and it seemed to really shed light on what his -- you know, his strong and what he was going to have difficulties with. can you expand upon that? is that an mri or sorts? >> it's an eqg that they do. they put a lot of -- how do you call this, electro, thank you, on his head and he has to stay still and they do a map -- they kind of read the activity on his brain for a period of time. it's very expensive. we had it in arizona. but it's so helpful.

so i wouldn't suggest that for every family, if they have to come up with the money out of their own pocket because ours cost us $3500. and if they can have the insurance, some kind of help, that would be very helpful because it really tells you right from the start whether you should plan on putting your child in the facility where he will be 24/7 taken care of by people or he can take care of himself when he grows up. so you can start investing money to fund a good facility for him or you can invest your money into developing activities for him to help himself. so that kind of give you a roadmap right from the start and we were lucky enough to come across this doctor who did this. >> does anyone have anything to add to that? dr. shih? is it not covered by insurance? does anyone know? >> not at all. >> and it's an eeg, like --

>> ekg. >> ekg. >> i think it's an eeg. >> eeg. >> so what they do for seizures and other types of brain function. thank you very much. i yield back, mr. chairman. >> i'd like to thank our -- would the witnesses like to add anything further? i would like to thank -- and ms. cassidy, thank you for your testimony from belfast, ireland -- northern ireland. i would like to close with this statement that dr. shih made and i think again it capitalizes why we're concerned. he note in his testimony as child mortality decreases, simple math predicts an increase in the number of children with developmental disabilities. so instead of seeing mortality and developmental disorders like autism as two distinct challenges they should be tackled as parts of the same problem.

continuing in his statement, you said just a few moments ago, autism speaks and our partners around the world believe that by addressing autism and related disorders now, south africa and other developing countries can get ahead of the curve, help maximize outcomes for affected individuals and families and minimize long-term cost to society. we have a pandemic with autism. hopefully we can launch and do much more with the global health initiative and all the other related efforts at the u.n. that and the country-specific level to mitigate this devastating developmental disorder. i thank you and we are adjourned. [inaudible conversations]

[inaudible conversations] [inaudible conversations]

[inaudible conversations]

>> kurt campbell said the u.s. will announce it's national strategic and security goals for southeast asia sometime is in the next few days. at this discussion on u.s. policy in the region, secretary

campbell also discusses meanmar and preparations for two summits later this year. >> it's an honor for me to welcome you to csis here this morning for a very timely and special edition of the bayan tree leadership forum. we created this banyan tree leadership forum for occasions just like this. to have dedicated leaders from the united states, southeast asia, australia, new zealand and the pacific to share their insights and perspectives on timely and important trends that will impact all our lives. trade and investment to security and political affairs to foreign policy and the important basis for all of the above people to people ties. we're very lucky today to have a good friend, assistant secretary of state kurt campbell with us here this morning.

he's a leader in the churchillian tradition. he's a leader from the church. [laughter] >> he says what he means. [laughter] >> there's no comment on body somata-type. seriously, he leads from the front. [laughter] >> he means what he says and he follows through. he's thoughtful, creative, and he backs good ideas with energy and action, and you can't say that about many people in certain leadership roles. although kurt has provided brilliant ideas and strategies that he and secretary clinton have deployed throughout asia and i can't stand here without share an example that he was cedar in my consciousness. we were together in christ church, new zealand when the devastating earthquake on february 22 hit us like a

freight train during lunchtime. it was a tragic day and a lot of us will never forget it. about 150 american leaders including young leaders were on hand for the partnership forum which is a vehicle for strengthening and reinvigorating our ties with new zealand and kurt, of course, has been a major driver of this initiative. they, with the support of our friends in new zealand they evacuated us to the antarctic air base and we were waiting to be evacuated on the airways. it was kurt campbell who was standing in dust and earthquake ooze along with his new zealand counterpart and he really took charge. he took charge when the chips were down. he took charge of that evacuation. he sorted out who would go first on the airplanes, who would go when, and he wasn't first. he was the last on that airplane. [laughter] >> and he took great care and i was really impressed by this.

he took great care to personally sit down with the young leaders and put them at ease as we evacuated our way out of there. i can't tell you how impressed i was with leadership and action like that. kurt, this is an important time for u.s. foreign policy and asia. that's an understatement and i'm sure you'll explain why. with the secretary planning to head out to the asean forum and the president looking for his east asia summit as well as the asean summit and host the apec summit in honolulu this past summer, this is a timely talk. i don't think many people in washington can put 300 people in a room on the morning after memorial day holiday. please welcome my friend and our assistant secretary of state, kurt campbell. thank you. [applause]

>> thank you very much, ernie. i have never seen a program stood up more quickly and have greater influence than the one ernie has put together in the course in a couple years and i have more to say about that as the discussion goes. let me welcome here on a very hot -- is it august or -- but there's no climate change. welcome everyone here to csis and let me take a moment to welcome all our good friends and all the ambassadors from asean and my colleagues and friends and lots of people in the audience, ambassador moore and former ambassador carla hills. what i would like to talk about today is our engagements and how we see next steps when it comes to southeast asia in particular. i would be happy to take questions and comments about the whole of asia but the particular focus today is going to be on

southeast asia on a whole and i would like to begin with something that's extraordinarily important. i think occasionally you will find discussions about whether the united states has -- is back in asia or particularly stepped up our game. i would tend and i would like to try to reject some of those concepts because i think one of the most important things for american foreign policy and asia as a whole is that for the last 30 years it has been primarily partnership. and the fact that we can count on strong bipartisan-centrist commitment from both parties to an expansive engaged strategy in asia has been one of the principal achievements of american foreign policy in asia and it has been one of the most important things that we can count on going forward. and so i think one of the things that i would like to see going forward, and i would counselor my friends in my own administration is to underscore the bipartisan quality of what we have done and what we will seek to do in working closely

not only with friends on the other side of the aisle but with the legislative branch. clearly, the legislative branch has an enormous set of equities and interests in southeast asia and we've tried to work closely with them as we go forward. that being said, i think it is clear that when president obama and secretary clinton came in, one of the areas that they looked at and they said, look, we want to intensify our engagement is in southeast asia and i think when you have a seen over the course of the last 2.5 years is the beginning of that process. and i say beginning because in order to be successful, particularly, in southeast asia, it is going to be important to continue this, to make sure that it lasts not only this administration but further future administrations. it's absolutely essential to be able to underscore an enduring long-term stepped-up engagement in southeast asia.

when clinton and president obama regularized travel. secretary clinton have been to asia 17 times. she's almost completed the tour. she has a couple of remaining countries she'd like to go to all the southeast asian nations during the time of her tenure in office. we've signed the treaty of amity and cooperation. it's an important sort of guidepost to get through that allows us to have more intense engagements on a variety of not only bilateral initiatives but institutional initiatives as well. president obama instructed the state department to undertake a burma review and we went through that process over the course of the first eight months and we put in place very careful new strategy which is designed both to keep our pressure in place but also to explore opportunities for consequently engagement. we appointed pope we were one of the first nations to