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DIRECT SUPPORT PROFESSIONALS - As we approach Christmas and the other religious holidays in 2025, it is timely to say a word about workers who often seem driven by a higher power.
They are workers among the 1.4 million Direct Support Professionals (DSPs) nationwide, according to the National Alliance for Direct Support Professionals, who provide daily support services to adults and children with autism, cerebral palsy and other developmental differences. DSPs assist and teach clients in daily living skills in pursuit of semi-independent or independent living --and whenever possible with adults a job or daily meaningful activity.
Turnover in DSP positions is high, and the quality of services among DSPs is uneven. The clients are often very challenging to work with. Pay is low, and the paths of mobility for DSPs currently are few.
Yet, within this DSP workforce are workers who bring remarkable abilities to connect with clients, including those who are non-verbal or very severely impacted. These workers bring remarkable commitment, empathy, and patience. They operate on religious and spiritual levels, different from other workers. God’s tender mercies.
The Craft of the DSP
These workers also bring a craft to their jobs: an attention to detail, striving for excellence in service, pride in a job well-done that goes well beyond the hours billed. The DSP is often described as an “unskilled” position. Nothing could be further from the truth. The skills that distinguish the DSP include the teaching skills for independent and supportive living. They also include the soft skills of connection.
Over the past 35 years, I have met several DSPs who perform their duties with craft and commitment. I can probably best illustrate with one of them, Christine, who worked with our son Will for over twenty years, and who continues in her work today.
The Craft of “The Autism Whisperer”
Christine came to work with us in 1991, shortly after Will was diagnosed with autism at age two. She had no special training in autism. But from the start, Donna and I were struck by her ability to connect with Will and the calmness she brought to our household.
After Will’s diagnosis, Donna and I scrambled to understand autism and Will’s strange and disturbing behaviors. For more than a decade, I kept detailed notes on his behaviors and our correspondence with autism specialists. William’s behaviors paralleled those being observed among children with autism: rigidity, routines and distress when a routine was not followed, talking to himself, flopping around.
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In 1994, the prominent economist Dr. Thomas Sowell wrote about his son John, who didn’t speak until he was almost four years old, and started a discussion group among parents with other “late talking” children. In correspondence with Dr. Sowell, I wrote of Will:
“He is now nearly 5 years of age. He goes to a special education program at the San Francisco Unified School district, Will often stares out the window and talks to himself, repeating verbatim scenes from a Winnie the Pooh video (‘Oh, Pooh Bear, where are you?’) or Thomas the Tank Engine, (‘I’m sorry I was so cheeky, said Thomas’).
“His behavior at the school is frequently odd and inappropriate. He does not interact much with other children. At the park he might go up and down the slide, talking or laughing to himself. He can go off like a roman candle if certain patterns are not followed. His tantrums at times can be so severe that he seems possessed.”
Christine was not able to “cure” his autism or to dramatically change his behaviors. These behaviors continue in various forms to the present. But she was able to help him manage the behaviors. She had an ability to sense when he was agitated and how to address this agitation. She was able to get him to focus in ways that other teachers could not, and to provide academic assistance. Teachers from the special education program turned to her for advice on Will.
A number of these special education teachers referred to Christine as “the autism whisperer.”
“An Innate Intuition About How Our Kids Think and Feel”
Over time as Will went on to college, Christine also did so. She earned a degree from City College of San Francisco and then a BA from San Francisco State University. With her BA, she had opportunities to go into administrative or supervisory roles in disability services. But she wanted to stay in direct services.
Today she continues to work with children and young adults with autism and other neurological conditions. She has been with most of her clients for eight years, ten years or more. One of the families she works with has two children with neurological conditions: Anthony and Carlos.
Anthony, 19, has ATR-X syndrome, a very rare condition, which presents as global developmental delay—he’s nonverbal, cognitively impaired, orthopedically impaired and visually impaired. Christine comes in each morning at 7:00 am to prepare breakfast for him and help him feed himself and get ready for the day.
Christine explained her approach with Anthony:
“My experience with Anthony is that he is a very happy young man. I think it’s important when a child is non-verbal and is not fully independent that a caregiver give them the same respect and dignity that they give to any other child in their care.
“I know that he is happy to see me when I greet him in the morning. He will always give me a smile and that has been our special connection. I know that he enjoys breakfast because he has a particular sound that he makes when he is enjoying the food I make for him.”
I asked Anthony’s mother Anna about what sets Christine apart from other caregivers:
“What really sets her apart is she just has this innate intuition about how our kids think and feel. She can just put herself right in their shoes and understand what they are experiencing.”
Anna also noted Christine’s commitment beyond the hours she is paid for, and her ability as a problem solver:
“She’s not just clocking in and clocking out. She’s not just there to do the tasks that we’ve asked her to do. She always goes above and beyond and she does things that are for the benefit of the kids.
“I have a WhatsApp group of my caregivers, and she’s on it. She’s the only one who pays attention to everything that we post on there. Even when she’s not here for those hours when we’re doing an outing or something, she just still is on top of how we do things.
“For Anthony, Christine some comes in with some ingredients and some foods that she thinks he might really like and she introduces him to those things, and gets so much satisfaction out of his pleasure in eating, and with that comes the self-feeding. It all just kind of comes together, because he enjoys so much what he’s eating so that he’s motivated to spoon, to fork, all these life skills that he’s been working hard on.”
Another son, Carlos, 12, has autism. Of his connection with Christine, Anna adds:
“She just kind of knows when to step in and when to step back. When she’s welcome in his bubble, and when he just needs a little bit of space.”
The Backpack and the Timer
Christine has worked with for 10 years with Andrew, 13, who is also a person with autism, and whose family also lives in San Francisco. Andrew has limited language, will bolt away from Christine at times (“elopement”), and can become upset and noncompliant (refusing to put on his shoes, walk out the door, get on or off the school bus, go into certain areas). Christine talks about how she has come to handle these behaviors, and how much she finds enjoyment in working with him.
“When he was bolting, I basically always had a backpack on him that I had a hold of. It was interesting because he would ask me to take my hand away and he would sometimes say, ‘Andrew run.’ I would remind him that I needed to hold the backpack to keep him safe. Thank heavens that stage is over.
“In addressing non-compliance, I have found that he responds well to a timer. I tell him that if he needs more time, that’s fine and we can set the timer. Most of the time the timer doesn’t get down to one before he says, ‘I’m ready.’
“I’ve always walked with Andrew so he loves going for walks out in the community. I have kept it consistent to expose him to different places, walking different streets home. Now that he is older, he is exhibiting preferences on which way he wants to walk. I think it’s important to acknowledge that he does have some control in that. I will let him know that it is his turn to choose which way we walk home and if he tells me with words, and doesn’t pull me, I will honor his request.
"During these times, we have conversations based on his language ability that are very precious to me and unique to our everyday routines and bond.
“Lately he has been on a roll of just being happy, responsive and really working hard on following cues. He has been so happy when we’re out in the community, and he loves to connect by linking my arm as we walk."
Andrew’s mother noted that the Applied Behavior Analysis (ABA) therapists who work with Andrew seek out Christine’s advice. “The ABA therapists see Christine’s gift, her ability to teach Andrew living skills, to take him out into the community, to understand what he is feeling at any time. For our family, she is a blessing.”
Tender Mercies
Christine has pointed to her speech impediment as a source of her ability to connect with children. When she was younger she recalled she was teased for this impediment. In my observations, a major source of her behavior lies in her deep religious values as a practicing Catholic.
This is a common source among the gifted DSPs I have had opportunity to know. Their lives are rooted in religion. They think of their work as service to others: care, comfort, divine affection, deliverance.
Earlier this year, the California Policy Center for Intellectual and Developmental Disabilities (CPCIDD) issued a detailed report on the DSP Workforce Shortage in California. CPCIDD researchers documented the shortage of DSPs to serve California’s growing population of Regional Center clients with intellectual and developmental disabilities--now up to 458,000 clients statewide. It documented the low wages and incomes of DSPs (32% of the DSPs qualified for Medi-Cal funding) and an annual turnover rate approaching 40%.
The report called for higher reimbursement rates for providers, as well as training for DSPs and building career ladders to encourage retention. All of these recommendations make sense, and are overdue.
But by themselves they will not bring us more DSPs like Christine. She and other religious and spiritual individuals like her are driven by values beyond wages and career ladders. It is by fostering strong cultures of religion and service, outside of government, that we are most likely to expand the realm of tender mercies in 2026.
(Michael Bernick is the former Director of California’s Employment Development Department and previously served eight years on the BART Board. He is currently employment counsel at Duane Morris LLP, a Milken Institute Fellow, and a Fellow at the Burning Glass Institute. A leading voice on workforce issues, Bernick focuses on employment strategies for neurodiverse populations. His latest book is The Autism Full Employment Act. He is a regular contributor to CityWatchLA.com.)
